AMOEBIASIS

AMOEBIASIS
Tropical & Infectious Disease Division
Child Health Department
FK USU
Medan

 DEFINITION :
Infection of Entamoeba hystolitica with or
without clinical symptoms
DISTRIBUTION :
- Worldwide

- Especially in tropical and subtropical areas

INCIDENCE :

10 % of the world population

CONTAMINATION
Eating or drinking food which contaminated with
Entamoeba histolytica cyst

CONTAMINATION BY :
1. Water source that contaminated
2. Contamination by host who works with food / drink
3. Contamination by fly or insect that contain parasites
4. Use of human faecal as fertilizer
5. Lack of personal hygiene

CLASSIFICATION
A. Asymptomatic
B. Symptomatic
I. Intestinal Amoebiasis
- Dysentery
- Non Dysentery Colitis
- Amoeboma
- Amoebic appendicitis
- Complication and sequele :
Perforation & peritonitis
Bleeding

Intussusception
Stricture

II. Extra Intestinal Amoebiasis

1. Hepatic
A. Acute Non suppurativa
B. Liver abscess
2. Cutaneous

3. Other organs : lung, brain, spleen

INTESTINAL AMOEBIASIS
1. Asymptomatic Cysts Passer
2. Symptomatic

AMOEBA DYSENTRI
CLINICAL SYMPTOMS:
Incubation period: Vary, days weeks - months
( 3 weeks - 3 months)
Symptoms :
Bloody and mucous faeces
Classic symptoms :
- Initial : Waterrhy stool with mucous
- Late : Frequency
Faeces with mucous or blood and mucous
mixed in stool or melena

 Defecation frequency is less than Dysentri basiler :

5 - 10 times a day
Manifestation : vary depends on type and lesion
Endemic area with high patogenic strain
symptoms suddenly appears
More often
Symptoms appears slowly, one or more symptom

appears followed by : abdominal cramp, nausea,

vomit and wanting to defecate

 If colon involved :
- Great pain in whole abdomen
- Great dysentry
- Weight loss
- Dehydration
- And accompanied by liver involvement or
perforation of the intestines
If caecum involved :
Symptoms like acute or subacute appendicitis
Recto Sigmoid :
First complaint : dysentry

SUB ACUTE TYPE

Symptoms is mild
Few clinical manifestations
CHRONIC TYPE

Mild symptoms with a longer interval

Followed by normal defecation or constipation with
reactivation period of acute phase

COMPLICATION & SEQUELE

1. Local :
- Bleeding

- Perforation

- Stricture

- Amoeboma

- Amoebic appendicitis
2. Extra Intestinal :
- Liver abscess

- Lung abscess

- Brain abscess

- Skin amoebiasis

- Genitalia amoebiasis

DIFFERENTIAL DIAGNOSIS
1. Dysentry basiler

5. Schistosomiasis

2. Ca Colon

6. Malaria

3. Colitis ulserativa

7. Colitis due to radiation

4. Trichuriasis

DIAGNOSIS
Faecal examination : Trophozoit form that contain
erythrocyte or cyst

TREATMENT
Without complication, anti amoebic treatment gives a
satisfactory result

1. METRONIDAZOLE
Dose : 50 mg / kgBW / day
Given 1 or 3 days
2. TINIDAZOLE
Dose : 50 mg / kgBW / day, single dose

3. ORNIDAZOLE
Dose : 50 mg / kgBW / day, single dose

ADDITIONAL THERAPY
If there is a hemorrhagic or dehydration

manifestation, then it should be treated first