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Amebiasis

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Amebiasis
Diagnosis

Amebiasis (amoebic dysentery) — the infectious disease which is followed by a canker of a large intestine, a long current and possible formation of abscesses of a liver, easy and other bodies.

Etiology. The activator — Entamoeba histolytica — belongs to type of protozoa, in a human body it can be found in the form of vegetative forms (small and big) and cysts. Its vegetative forms are very sensitive to adverse effects: disinfecting solutions, boiling destroy them instantly. Cysts possess relative stability, remaining in water till 1 months.

Epidemiology. An infection source — the patient or the carrier of amoebas. The illness is widespread in the countries with tropical and subtropical climate. In the former USSR meets more often in Transcaucasia, Central Asia, Primorsky Krai. Incidence of an amebiasis has sporadic character.

Pathogeny. With food or water the cyst gets to a small bowel where as a result of a metatsistichesky stage of development the small vegetative forms settling then in a large intestine are formed. At overwhelming number infected amoebas live on the provision of commensal, without causing any disturbances. However under the influence of various adverse factors of an amoeba can sometimes be implemented into a gut wall, turning into big vegetative forms and causing pathological process. In the place of implementation of amoebas the focal hyperemia, thrombosis of small vessels with the subsequent necrosis of fabrics and formation of various sizes of ulcers with the subdug edges are observed. Ulcers can penetrate all thickness of a wall of a gut therefore there are bleedings, peritonitis, commissural process. Damage of blood vessels leads also to drift of amoebas a blood flow in various bodies and fabrics (a liver, kidneys, a brain) where they settle, promoting in the subsequent to formation of abscesses.

Clinic. An incubation interval — from 2 weeks to several months. The disease develops gradually, is much more rare — sharply. Is followed by increase of a chair, rumbling, emergence of pain mainly in the right ileal area. Tenesmus are rare, usually at pan-colitis.

In a chair pathological impurity in the form of vitreous slime and blood which give it a characteristic type of "crimson jelly" early are found. The stomach is blown moderately up, at a palpation the spasm of guts is defined. In cases of an uncomplicated amebiasis temperature normal or subfebrile, intoxication is expressed unsharply. Disorders of food at patients are observed usually at the long course of a disease. The liver at most of patients is moderately increased, function it is not broken. Expressiveness of the local changes revealed at a rektoromanoskopiya depends on localization and weight of defeat. More often puffiness and a focal hyperemia of a mucous membrane of distal departments of intestines with typical ulcers come to light (the subdug edges, a necrotic plaque at its bottom, a hyperemia zone around ulcers). Usually the disease gets a chronic current with alternation of the periods of remissions and aggravations. From complications are noted: intestinal bleedings, perforation, cicatricial narrowings of intestines. The most frequent abenteric complications are hepatitises and abscesses of a liver. Less often abscesses of lungs, a brain, etc. meet. Abenteric complications of an amebiasis can present great difficulties for recognition and demand differential diagnosis with the abscesses caused by other activators.

Laboratory diagnosis of an amebiasis is reduced to detection of the activator in Calais, contents of abscesses. An indispensable condition is research of material no later than 15 — 20 min. after receiving it from the patient. In recent years the possibility of use of a method of fluorescent antibodies for diagnosis of an amebiasis is proved, especially at abenteric complications.



 
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