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Amoebiasis – Causes, Symptoms and Treatment

Amoebiasis is an infectious disease caused by the parasite Entamoeba histolytica. It primarily affects the intestine and can spread to internal organs in severe cases.

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Things worth knowing about "Amoebiasis"

Amoebiasis is an infectious disease caused by the parasite Entamoeba histolytica. It primarily affects the intestine and can spread to internal organs in severe cases.

What is Amoebiasis?

Amoebiasis is a parasitic infectious disease caused by the single-celled organism Entamoeba histolytica. The parasite primarily affects the large intestine but can, in severe cases, spread to other organs such as the liver, lungs, or brain. Amoebiasis is one of the most common parasitic diseases worldwide and is particularly prevalent in tropical and subtropical regions, as well as in areas with limited sanitation.

Causes and Transmission

Infection occurs through the oral ingestion of cysts, which are the resistant, dormant forms of the parasite. These typically enter the human body through contaminated water or food. Direct person-to-person transmission via poor hand hygiene is also possible.

Drinking contaminated water
Consuming raw or unwashed fruits and vegetables
Fecal-oral transmission due to inadequate hygiene
Traveling to high-risk areas (Asia, Africa, Latin America)

Symptoms

Many people infected with Entamoeba histolytica develop no symptoms or only mild discomfort. However, a portion of infected individuals develop an active illness with varying degrees of severity.

Intestinal Symptoms (Intestinal Amoebiasis)

Diarrhea, sometimes with blood and mucus (amoebic dysentery)
Abdominal cramps and pain
Nausea and vomiting
Fever

Extra-intestinal Amoebiasis

In rare cases, amoebae travel through the bloodstream to other organs. The most common extra-intestinal manifestation is a liver abscess, which presents with right-sided upper abdominal pain, high fever, and general malaise.

Diagnosis

The diagnosis of amoebiasis is established using several methods:

Stool microscopy: Detection of cysts or trophozoites (the active form of the parasite) in the stool
Antigen test: Detection of parasite-specific proteins in stool using ELISA
Serology: Blood test to detect antibodies, particularly useful in liver abscess cases
PCR test: Molecular detection of the pathogen, highly sensitive and specific
Imaging: Ultrasound or CT scan when a liver abscess is suspected

Treatment

Treatment of amoebiasis depends on the severity of the infection and the organs involved.

Drug Therapy

The first-line treatment for symptomatic amoebiasis is metronidazole, an antibiotic from the nitroimidazole group that acts against the active tissue forms of the parasite. This is typically followed by a luminal amoebicide such as paromomycin to eliminate any remaining cysts in the intestine and prevent further spread.

Metronidazole: 7–10 days, for the treatment of invasive disease
Paromomycin or diloxanide furoate: Follow-up treatment to eliminate intestinal cysts

Liver Abscess

A liver abscess is also treated with metronidazole. In certain cases, drainage of the abscess may be required.

Prevention

Preventive measures are especially important when traveling to high-risk regions:

Drink only boiled or purified water
Avoid raw foods or wash and peel them thoroughly
Wash hands regularly and thoroughly
Avoid street food in high-risk areas

References

World Health Organization (WHO): Amoebiasis. Weekly Epidemiological Record, 1997.
Petri WA Jr., Singh U.: Diagnosis and Management of Amebiasis. Clinical Infectious Diseases, 1999.
Stanley SL Jr.: Amoebiasis. The Lancet, 361(9362):1025–1034, 2003.

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