2. History
• 5 years old boy admitted through
GIT clinic with :
• Hx of on/off Abdominal pain.
• bloody diarrhea and fever for
last 8 month.
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3. History
• There was 5 attacks . Each with
bloody stool with mucus and
documented fever.
• Abdominal pain on/off with or
without the attacks periumbilical,
colicky no radiation mild to
moderate in severity no known
aggravating or reliving factors.
• Assosiated with tenesmus.
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4. History
• 1st attack occurred after swallwing
water from swimming pool.
• No vomiting.
• No jundice.
• No arthralgia.
• No rash.
• No travel.
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5. History
• Admitted twice in MCH due to
E.histolitica in stool .
• Received 5 courses of
metronidazole for 10 days.
• Seen in ID clinic given
metronidazole followed by furate
for 10 days.
• Bloody stool stopped but still on
off abdominal pain.
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17. introduction
• Entamoeba histolytica infection is
one of the significantly common
pathogenic protozoa
encountered in Saudi Arabia.
• Approximately 10% of the world's
population is infected by
amebiasis.
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19. ETIOLOGY
• Many patients previously
described as asymptomatic
carriers of E. histolytica based on
microscopy findings were
probably infected with E. dispar.
• Microscopy alone can’t
distinguishe between E.histolytica
and E. dispar .
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20. EPIDEMIOLOGY
• true prevalence of E. histolytica
infection is not known due to
inability to differentiate.
• Amebiasis is highly endemic in
Africa, Latin America, India, and
Southeast Asia.
• In KSA no data.
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21. EPIDEMIOLOGY
• 3rd leading parasitic cause of
death worldwide
• direct fecal-oral contact are the
most common means of infection.
• Infection is established by
ingestion of parasite cysts
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23. CLINICAL
MANIFESTATIONS
• colicky abdominal pains
• Diarrhea .bloody and mucoid
stained
• tenesmus.
• fever . in only ⅓ of patients. But
may indicate liver involvement.
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24. investigation
• CBC: anemia and slight
leukocytosis
• LFT: high liver enzymes mainly
ALK if liver involved.
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25. investigation
• Stool examination microscopy :
• 3 fresh stool samples (within 30
min of passage)
• has a sensitivity of 90% ,but
microscopy cannot differentiate
between E. histolytica and E. dispar
• Exception: unless phagocytosed
erythrocytes, which are specific for
E. histolytica.
• negative in >50% of patients with
documented amebic liver abscess.
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26. investigation
• ELISA : detection antigens in
stool by enzyme-linked
immunosorbent assays.
• PCR from stool.
• Serology :serum antiamebic
antibody
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27. investigation
• Sigmoidoscopy and/or
colonoscopy: can be performed
either to make the diagnosis of
amebiasis or to exclude other
causes of the patients'
symptoms.
• Ultrasonography, CT, or MRI : for
localization.
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31. TREATMENT
• E. histolytica infection is
asymptomatic in about 90% of
persons, but it has the potential to
become invasive and should be
treated.
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