amoebiasis-clinical features,amoebic liver abscess, amoeboma, complications of amoebiasis

8. Clinical Presentation- Intestinal Amoebiasis:
Incubation Period is 2-6 weeks.
 Abdominal pain and tenderness in the lower
abdomen,painful sudden bowel evacuation(tenesmus) with
recto-sigmoid involvement and diarrhoea developing over a
period of one to several weeks.
In mild to moderate colitis,patient has mucus diarrhoea,but
no blood in stool.
Patients with severe colitis pass offensive and bulky stools
containing blood and mucus and have fever and lower
abdominal cramps.

9. Gross pathology of intestinal
amebiasis showing extensive
ulceration

15. Physical findings:
 Hepatomegaly
 Localised tenderness
 Rales,rhonchi
 Localised intercostal tenderness
 Jaundice
 Epigastric tenderness

16. Diffuse liver tenderness is elicited,i.e tenderness on
antero-posterior compression of the lower part of
the chest on the right side.

17. A localised area of maximum tenderness must be looked for.
This area may lie subcostally; if not, it is often found by thumb
pressure in the intercostal space.One of the cardinal signs of
liver abscess.

18. Elicited by palpating with the tips of the fingers all over the hepatic area
including the right lower chest (anterior and posterior and subcostal area.
As against intercostal tenderness which could be present in pleurisy etc.,
point tenderness is more diagnostic of liver abscess and is also a useful
guide as to the side for abscess puncture. Point tenderness and intercostal
tenderness are often elicited even in the absence of diffuse liver
tenderness. The former is often elicited in the postero-lateral area of a
lower right intercostal space

24. This patient presented with a case of invasive
extraintestinal amebiasis affecting the cutaneous region
of the right flank causing severe tissue necrosis. Here we
see the site of tissue distruction, pre-debridement.The
wound then be covered by autologous skin grafts.

25. Intestinal Amoebiasis Extra-Intestinal
Amoebiasis
Asymptomatic infection(cyst
passers)
Non-suppurative amoebic
hepatitis
Acute amoebic dysentery Amoebic liver abscess
Intestinal amoebiasis
complicated by-
Amoebic liver abscess
complicated by-
•Toxic megacolon •Empyema
•Fulminant amoebic colitis •Pericarditis
•Amoeboma •Peritonitis
•Amoebic peritonitis •Pulmonary amoebiasis
•Perianal ulceration •Cerebral amoebiasis