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Amoebic Dysentery – Causes, Symptoms & Treatment

Amoebic dysentery is an intestinal infection caused by the parasite Entamoeba histolytica, leading to bloody diarrhea, abdominal cramps, and fever.

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Things worth knowing about "Amoebic Dysentery"

Amoebic dysentery is an intestinal infection caused by the parasite Entamoeba histolytica, leading to bloody diarrhea, abdominal cramps, and fever.

What Is Amoebic Dysentery?

Amoebic dysentery is an infectious disease of the intestine caused by the single-celled parasite Entamoeba histolytica. It is one of the most significant parasitic causes of diarrheal illness worldwide, primarily affecting people in tropical and subtropical regions where access to clean drinking water and adequate sanitation is limited.

Causes and Transmission

The parasite Entamoeba histolytica is transmitted via the fecal-oral route. Common sources of infection include:

Drinking contaminated water
Eating raw or unwashed fruits and vegetables
Poor hand hygiene, especially after using the toilet
Direct contact with infected individuals

The parasite enters the digestive tract as hardy cysts, transforms into active trophozoites in the intestine, and invades the gut wall, causing ulcers and inflammation.

Symptoms

The incubation period is typically one to four weeks. Common symptoms of amoebic dysentery include:

Bloody or mucus-containing diarrhea (multiple times daily)
Severe, cramping abdominal pain
Painful urge to defecate (tenesmus)
Nausea and vomiting
Low-grade fever
General fatigue and weakness

In severe cases, the infection can spread beyond the intestine. A particularly serious complication is the amoebic liver abscess, in which pus accumulates in liver tissue, causing high fever and intense pain in the upper right abdomen.

Diagnosis

Amoebic dysentery is diagnosed using several methods:

Stool examination: Microscopic detection of cysts or trophozoites in stool samples
Antigen testing: Detection of Entamoeba histolytica antigens in stool via ELISA
Serology: Blood tests to detect antibodies against the parasite, especially in cases of extraintestinal spread
PCR testing: Molecular detection of the parasite in stool
Imaging: Ultrasound or CT scan to identify liver abscesses

Treatment

Treatment depends on the severity of the infection:

Medication

Metronidazole or Tinidazole: First-line treatment for active, invasive intestinal and hepatic amoebiasis
Paromomycin or Diloxanide furoate: Used to eliminate intestinal cysts following treatment with metronidazole

Supportive Care

Adequate fluid intake to replace fluids and electrolytes lost through diarrhea
In severe cases, hospital admission and intravenous fluid replacement may be necessary

Prevention

The following precautions are recommended to prevent amoebic dysentery, especially when traveling to high-risk areas:

Drink only boiled or bottled water
Avoid raw fruits and vegetables that have not been peeled or washed by yourself
Wash hands thoroughly and regularly with soap
Avoid street food in regions with poor hygiene standards

References

World Health Organization (WHO): Amoebiasis. WHO Fact Sheet. Geneva, 2023. Available at: https://www.who.int
Fauci AS, Kasper DL et al.: Harrison's Principles of Internal Medicine. 21st edition. McGraw-Hill Education, 2022.
Centers for Disease Control and Prevention (CDC): Amebiasis – Parasites. Atlanta, 2023. Available at: https://www.cdc.gov/parasites/amebiasis

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