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PubMed1984

Nitroimidazoles in the treatment of trichomoniasis, giardiasis, and amebiasis.

Nitroimidazoles have been extensively evaluated in the treatment of trichomoniasis, giardiasis, liver and intestinal amebiasis. The most widely used are metronidazole, tinidazole, ornidazole, and secnidazole. Tinidazole, ornidazole, and secnidazole have a much longer half-life than metronidazole, allowing single-dose or once daily administration. Nitro-5-imidazoles remain extremely effective drugs for treating protozoans, Trichomonas vaginalis, Entamoeba histolytica, and Giardia intestinalis. Although all are suspected of potential carcinogenicity, they are the drugs of choice for treating protozoal infections.

Amebiasis↗

PubMed2001

Protective immunity to amebiasis: new insights and new challenges.

Amebiasis, infection with the protozoan parasite Entamoeba histolytica, is the third leading cause of death from parasitic diseases. Despite its importance, we know little about protective immunity to amebiasis. Now, studies from a cohort of children in Bangladesh have provided some critical insights into immunity to intestinal amebiasis. Children with mucosal IgA antibodies to the amebic adherence lectin were found to be resistant to reinfection with E. histolytica. However, immunity was short-lived, and approximately 20% of children in the cohort had a second episode of E. histolytica infection during the study period. Theses findings indicate that immunity to amebiasis can develop in some children after intestinal infection, but protective immunity may be transient, and its importance in preventing disease remains to be established.

Animals↗

PubMed2005

Detection of serum antibody to Entameba histolytica in various population samples of amebic infection using an enzyme-linked immunosorbent assay.

Microscopic identification of Entameba histolytica in stool is insensitive to differentiate this pathogenic ameba from morphologically identical Entameba dispar. An enzyme-linked immunosorbent assay method was applied for diagnosing amebiasis by detection of E. histolytica antibody. A total of 258 sample sera were analyzed from five different groups including amebiasis patients, E. histolytica/E. dispar asymptomatic cyst carriers, patients clinically presumed to have intestinal and extra-intestinal amebiasis and healthy control. From 51 E. histolytica/E. dispar cysts passers identified by microscopy and culture, a positive anti-amebic antibody was measured only for eight specimens (15.6%) and 43 cyst carriers showed an absorbance less than cut-off likely due to E. dispar infection. These findings suggest usefulness of ELISA method in differentiation of Entameba species, in clinical laboratories less equipped with biological and biochemical methods or antigen capture kits.

Amebiasis↗

PubMed1983

A study with quinfamide in the treatment of chronic amebiasis in adults.

Quinfamide, a luminal amebicide, is a dichloroacetyl quinolol used to treat chronic and subacute intestinal amebiasis. Several previous dose-ranging studies have indicated that quinfamide is effective in a total dose of 300, 600, or 1,200 mg. The present study was undertaken to determine the efficacy of 100- and 200-mg doses, each given three times daily. A cure rate of 100% was found at a dosage of 100 mg/8 hr and of 93.3% at 200 mg/8 hr. These results indicate that quinfamide is an effective luminal amebicide at the doses studied.

Adolescent↗

PubMed1982

[Amebiasis].

Infections with Entamoeba histolytica do not necessarily cause disease in those infected. The parasite may act as commensal (cysts living in the bowel) or it may cause a broad spectrum of clinical illness. Some of the factors causing overt disease are poorly understood. An acute amebic dysentery is accompanied by bloody stools, abdominal pain and indigestion. The most important extraintestinal complication of an amebic infection is a liver abscess causing severe pain, fever, nausea and vomiting. The diagnosis of an amebic infection is based upon isolation of the parasite from the stools. Extraintestinal amebiasis is diagnosed - apart from the clinical picture - by serology. For treatment of intestinal amebiasis so-called contact-amebicides can be recommended. An amebic abscess of the liver usually responds well to dehydroemetine, metronidazole or any other derivative or imidazole and chloroquine. Surgical treatment of amebic liver abscess is only required if complications arise.

Amebiasis↗

PubMed1975

Massive development of amebas in the large intestine. Fedor Aleksandrovich Lesh (Lösch).

Fedor Aleksandrovich Lesh (Lösch) 1840-1903. Although Lösch was a distinguished Russian physician, little has been written about him in English. A graduate of the Medico-chirurgical Academy in St. Petersburg (1863), he defended a doctoral thesis on pulmonary embolism and infarction in 1866, and became an assistant professor of medicine in 1871. From 1872 to 1885 he was a lecturer on diagnosis at the Women's Medical College and a consultant to the Nikolayev Military Hospital. In 1885 he became Professor of Diagnostic Medicine at Kiev University where he remained until his retirement in 1897. In 1870, Lösch found Balantidium coli in the stools of two patients and made a detailed study of the clinical aspects of balantidiasis. In the same year he described in detail Giardia lamblia and Blastocystis hominis. Altogether, he published some 20 papers on the diagnostic and clinical aspects of various diseases, with special emphasis on the microscopic aspects of coprology. It was in 1875 (exactly 100 years ago) that Lösch, in this monumental paper, reported the clinical aspects of recurrent intestinal amebiasis, identified and described its cause, Entamoeba histolytica, and produced the disease in an experimental animal. This work on amebiasis was completed while he was assistant professor at St. Petersburg, on the wards of Prof. E. Eichwald. Clinicians will cherish the description of the patient's symptoms; protozoologists must be delighted by the description of the parasite and its motility; experimentalists will be nervous about his luck in infecting one of three dogs; and iconoclasts must derive satisfaction from Lösch's caution in not automatically assigning a direct causal relationship between the presence of the parasite and the disease.

Adult↗

PubMed1999

Comparative Study of the Efficacy and Tolerability of Secnidazole Suspension (single dose) and Tinidazole Suspension (two days dosage) in the Treatment of Amebiasis in Children.

Amebiasis caused by Entamoeba histolytica may be considered the most aggressive parasitic disease affecting human intestine, causing acute amoebic colitis and extra-intestinal diseases of high morbidity and mortality. 5-nitroimidazoles are the drugs of choice. In this multicenter, open and random clinical trial, the efficacy and tolerability of secnidazole suspension in a single oral dose of 1ml/kg was compared with 0.5ml/kg doses of tinidazole suspension given for 2 consecutive days to 303 Entamoeba histolytica-positive children aged 2 to 13. Patients with extra-intestinal complications were excluded from the study. Clinical and parasitological follow-up using the Faust and Kato-Katz method were carried out 7, 14, and 21 days after treatment. Clinical improvement/cure was observed in 93% of the patients in the secnidazole group and 91% in the tinidazole group. Parasitological success was reported for 77% and 63% of the secnidazole and tinidazole patients, respectively, showing a significant statistical difference between the two groups (p=0.007). Both drugs were well tolerated, and the adverse effects reported were mild, consisting mainly of digestive disturbances. This comparative study showed that a single oral dose of 1ml/kg of secnidazole produced a significantly higher parasitological cure rate than 2 doses of tinidazole. Secnidazole is a safe and effective drug for the treatment of uncomplicated intestinal amebiasis.

Journal Article↗

PubMedDate not supplied

[Amoebecide and trichomonacide activities of secnidazole in the laboratory].

A study of the experimental chemotherapeutic activity of secnidazole as compared to metronidazole is presented, including a summary of toxicity, metabolism, pharmacokinetic studies and preliminary results from clinical trials. Secnidazole is about twice as active as metronidazole against experimental amebiasis, equiactive against trichomoniasis, and possesses low toxicity. After oral administration to man, active concentrations in the blood persist much longer than in the case of metronidazole and notably longer than for tinidazole. In the clinic, its therapeutic activity against hepatic amebiasis seems to be at least equal to that of metronidazole; it appears also to be more active against acute intestinal amebiasis, and specially more effective against E. minuta and cyst carriers. Against vaginal trichomoniasis it was as effective as metronidazole after repeated administration for several days, and the percentage recovery rate was as high after one single dose as after daily administration. The digestive tolerance seems to be very satisfactory. In view of these findings, the advantages which secnidazole might possess over other 5-nitroimidazoles already in use for the treatment of amebiasis and trichomoniasis are discussed.

Amebiasis↗

PubMed1996

[Amebic liver abscess--personal observations].

In the period of 1989-1995 seven patients with amebic liver abscess were observed in Clinic of Infectious Diseases of Pomeranian Medical School in Szczecin. The diagnosis has been made on the base of epidemiological data, presence of intrahepatic defect by a scanning procedure of liver (ultrasonography, CT, scintigraphy) and positive serologic test for amebiasis. All patients were male of Polish nationality, 29-57 years old, who became ill after travel to Africa or India. Intestinal amebiasis was present only in two cases. Five patients had acute onset of disease and two chronic. The most common complaints included fever, abdominal pain, anorexia. A cough, chest pain, diarrhea or weight lose were less common. At physical examination paleness of skin, subjaundice, abdominal tenderness, hepatomegaly and sometimes pleural effusion have been observed. Laboratory tests revealed high RBS, leucocytosis and mild anemia. Slightly higher serum level of bilirubin, alkaline phosphatase were transient. Trophozoits of Entamoeba histolytica have been found in stool specimens of one only patient. Amebic antibodies tested with indirect hemagglutination (IHA) were present in all cases. Visual technics have shown abscess of 3 to 9 cm in diameter located at right liver lobe. Six patients have been treated with both chemotherapy (metronidazole or/and dehydroemetine) and "skin needle" aspiration. In two cases recrudescence of abscess has been observed after one and three years respectively. These two patients have been undergone second course of treatment with using not only needle aspiration and metronidazole/dehydroemetine but luminal agents as well.

Adult↗

PubMed1986

Cutaneous amebiasis of the face: a case report.

This paper describes a case of cutaneous amebiasis of the face in a 17-month-old girl. About four weeks prior to admission she had diarrhea with high suspicion of intestinal amebiasis. Fifteen days later she presented with edema of the right lower eyelid and epiphora. There was a vesicle in the inner angle of the eye which spontaneously drained, causing loss of the underlying tissue. The ulcer developed rapidly, destroying periorbital tissue. Both cytology and biopsy of the ulceration border showed abundant trophozoites of Entamoeba histolytica. Treatment was specific therapy and surgery.

Amebiasis↗

PubMed1995

Severe vaginal infection with Entamoeba histolytica in a woman who recently returned from Mexico: case report and review.

Genital amebiasis is a rare complication of infection with Entamoeba histolytica, even in areas where the pathogen is endemic. We describe a patient who apparently contracted intestinal amebiasis on a trip to Mexico and who presented with ulcerative vulvovaginitis 2 months later. Her condition rapidly progressed to severe necrotizing vulvovaginitis that required a radical vulvectomy. Histopathologic examination of the surgical specimen revealed the presence of E. histolytica trophozoites. The patient recovered after surgery and antiamebic therapy. We review the epidemiology and pathogenesis of genital amebiasis as well as therapy for this rare infection.

Aged↗

PubMed1985

Amebiasis presenting as rectal bleeding without diarrhea in childhood.

A 6-year-old boy with no history of foreign travel had presented with rectal bleeding without diarrhea for 2 months. Despite negative stool cultures, a diagnosis of intestinal amebiasis was made by colonoscopy with tissue biopsy. In cases of persistent rectal bleeding, even without diarrhea, a diagnosis of amebiasis should be considered. When routine stool parasite examinations are negative, unsuspected amebiasis may be diagnosed by sigmoidoscopy or colonoscopy with tissue biopsy.

Biopsy↗

PubMed2004

[Isolated pleural amebiasis: about one case in France].

INTRODUCTION: Isolated pleural amebiasis is exceptional in the world and specially in France. CASE REPORT: We report a case of acute isolated pleural amebiasis in a 56 year old man who did not travelled in endemic countries for the 20 past years. Chocolate-colored pus from the pleural puncture suggested the diagnosis. Positive amebic serology and above all, trophozoites (Entamoeba histolytica) in the pleural liquid confirmed the diagnosis of pleural amebiasis. Drainage was required and metronidazole was introduced. Other antibiotics were necessary to treat bacterial co-infection, which is frequent. Of interest, a nurse developed an acute intestinal amebiasis probably infected by pleural pus, an indirect confirmation of diagnosis. CONCLUSION: This diagnosis should be suspected even in low endemic areas in case of infectious pleurisy resistant to traditional antimicrobial regimens.

Entamoebiasis↗

PubMed1976

Counterelectrophoresis in the diagnosis of amebiasis.

One hundred eighty-one collected sera were tested for amebic serologic reactivity, using the counterelectrophoresis technic (CEP) and compared to the results of the agar gel diffusion (AGD) and the latex agglutination (LA) methods. Of 23 sera from patients with proven amebic liver abscess, 22 (96%) were positive immediately after CEP for one hour and all were positive within 24 hours. Of eigh t sera from patients with intestinal amebiasis, five were positive immediately and seven within 24 hours. Of 150 sera from patients with nonamebic illnesses, there were no positives with any method used. The CEP and AGD were in agreement on all sera tested.

Amebiasis↗

PubMed2002

Outbreak of amebiasis in Tbilisi, Republic of Georgia, 1998.

In 1998, we investigated a suspected outbreak of amebic liver abscesses caused by Entamoeba histolytica in the Republic of Georgia, using a case-control study. A questionnaire was administered and blood samples were obtained from cases and controls for serologic diagnosis. Medical records showed that E. histolytica infections were rarely diagnosed before 1998. However, from July through September 1998, 177 cases of suspected amebiasis were identified. Of 52 persons who had diagnosed liver abscesses, 37 (71%) were confirmed serologically to have antibodies against E. histolytica, compared with 11 of 53 persons (20.8%) diagnosed with intestinal amebiasis. In addition, 9-14% of asymptomatic controls were seropositive. Logistic regression identified the fact that interruptions in the water supply, decreases in water pressure, and increased water consumption were significantly associated with infection. The data support the hypothesis that drinking water was the source of infection, either because of inadequate municipal water treatment or contamination of municipal water in the distribution system.

Adolescent↗

PubMedDate not supplied

[Amebiasis. Has its clinical expression changed?].

In Mexico, like in other countries, there is an special interest for amebiasis because it represents a Public health problem; there are about 5 million people that in some time of their lives had tissue invasion by this parasite. 1-2% of mexicanas have intestinal amebiasis and probably there are 850,000 to 1,700,000 carriers of entamoeba cysts. 6% of the general population have circulating antiameba antibodies. In 1988 we studied the amebic hepatic abscess seen in the hospitals of the Instituto Mexicano del Seguro Social in the Valley of Mexico. During that year there were 396 patients with such illness (0.19% of hospital admissions) with a 1.01% mortality. Comparing this data with reports of 1969 there was a reduction in the number of patients and deaths. Also amebiasis has decreased in autopsy studies. However, we have not found recent variations in the clinical behavior of amebiasis. Advances in diagnostic methods and more liberal use of metronidazole have reduced the number of severely ill patients.

Amebiasis↗

PubMed1974

Use of stable, sensitized cells in indirect micro hemagglutination test for amebiasis.

Human "O" cells were fixed with pyruvic aldehyde, treated with tannic acid, and fixed with glutaraldehyde. The cells were sensitized with amoeba antigen and stored in a refrigerator. The sensitized cells were used periodically for the indirect hemagglutination test with a battery of sera from patients with intestinal amebiasis and confirmed and unconfirmed amebic liver abscess, and also from negative controls. The same battery was tested with cells sensitized with different batches of antigen and also with fresh sheep cells. None of the cells showed any reaction with negative control sera. The fixed cells remained sensitive and stable throughout the study. Reproducibility of the titers with the fixed cells within each day and from day to day was satisfactory. The titers with fixed human "O" cells were slightly lower than were the titers with fresh sheep cells. The advantages of using stable, sensitized cells are pointed out.

Aldehydes↗

PubMed1997

Encystation of entamoeba parasites.

Entamoeba histolytica is a protozoan parasite of humans, and the causitive agent of intestinal amebiasis. The disease-causing stage of the parasite is an osmotically sensitive ameboid form, which differentiates into a thick-walled cyst for transmission from person to person. The conditions within the human intestine that induce encystment of the amoeba are unknown, but studies using an amoebic parasite of reptiles are now yielding information about the molecules and host:parasite interactions involved in the process. An understanding of the amoeba's obligatory encystment pathway should provide an approach for interrupting the transmission of this parasite, for which there is currently no vaccine.

Amebicides↗