Amoebiasis spreads from person to person

Amoebic dysentery

definition

Amebiasis or amoebic dysentery is not a very common, but potentially life-threatening infectious disease. This diarrheal disease affects travelers to countries with a low standard of living or those returning to the tropics.

Amoebic dysentery is caused by the amoeba species Entamoeba histolytica. It nests in the large intestine of humans, where it constantly multiplies through cell division. It is transmitted primarily through unsanitary living conditions and above all through contaminated drinking water.

Occurrence

Amebiasis now threatens the vast majority of the world's population. Diarrhea is particularly widespread in tropical and subtropical regions such as Thailand, Kenya, Vietnam, Bangladesh and India. It is estimated that there are around 50 million new infections each year.

Transmission / contagion

Infection with amoebic dysentery can occur through contaminated food, especially through head-fertilized salads and vegetables, as well as through water and smear infections. The incubation period from infection to the onset of the disease varies widely and ranges from a few days to a few months to several years.

course

Amoebic dysentery can take place in three different ways. If the course is symptom-free (90% of cases), the sick person does not feel anything at all from the infection. The patient, who harbors and excretes the pathogens in his digestive tract, can, however, be the carrier of the infection. In invasive amoebic dysentery, the pathogens infect the digestive tract of humans and lead to an inflammation of the intestine with the formation of ulcers and abscesses. This leads to bloody, slimy diarrhea. In the advanced form of amoebic dysentery, the so-called extraintestinal amoebiasis, the pathogens also affect the organs outside the digestive tract - such as the liver, spleen, heart or urinary tract. Liver abscesses are then accompanied by a fever and a pronounced feeling of illness. Extraintestinal amebiasis can manifest itself years after infection.

If amebiasis is detected early and treated properly, it is usually harmless. Failure to do this can lead to serious to fatal complications such as liver abscesses or inflammation of the intestinal mucosa and peritoneum up to and including a ruptured bowel. The WHO estimates that around 100,000 people die each year as a result of the disease.

diagnosis

Typical symptoms of amoebic dysentery are abdominal and stomach cramps, fever, diarrhea and blood in the stool. The pathogens can be determined by examining blood and stool samples. Serum antibodies can also be determined in the blood. An ultrasound examination of the abdomen or a colonoscopy can also provide valuable information.

treatment

If the amoeba infestation is detected in good time, the pathogens can usually be treated well with antibiotics. If the infection leads to abscesses and infections in various organs, the treatment is often much more protracted. If massive abscesses occur, surgical treatment is sometimes necessary.

prevention

The best way to prevent amoebic dysentery is to avoid drinking open water or tap water in endangered tropical and subtropical areas. The chlorination of the water does not offer any protection. You should only use hygienically bottled mineral water for brushing your teeth. You should peel raw vegetables and fruits yourself. Severe abdominal pain or diarrhea must be examined and treated immediately by a doctor.

Differential diagnosis

The chronic inflammatory bowel disease ulcerative colitis can show similar or identical symptoms of amoebic dysentery. Bacterial liver abscesses can also make themselves felt in a similar way. The increasing number of amebiasis infections brought from abroad has made it more difficult to distinguish them from these and other similar diseases.