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Description : The discussion focuses on the etiologic agent, Entamoeba histolitica, its life cycle, transmission, pathogenesis and prevention

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Published on : Apr 01, 2020 | Views : 3242 | Downloads : 10

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Slide 1-

PGI PALINGCOD CASE DISCUSSION on Entamoeba hystolitica
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Life Cycle Transmission Pathogenesis Pathology Clinical Syndromes Diagnostic Tests Treatment OUTLINE
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REFERENCE Jameson et al. (2018). Harrison’s Principles of Internal Medicine( 20th edition). McGraw Hill Education. Carroll et al. (2016). Jawetz, Melnick, & Adelberg’s Medical Microbiology. McGraw Hill Education.
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LIFE CYCLE AND TRANSMISSION
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Figure 1. Life cycle of Entamoeba hystolitica Source: Harrison’s Principles of Internal Medicine( 20th edition) page 1569
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Figure 2. E . hystolitica cyst Figure 3. E . hystolitica trophozoite Source: Jawetz, Melnick, & Adelberg’s Medical Microbiology (27th edition) page 710
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PATHOGENESIS AND PATHOLOGY
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trophozoites invade the intestinal epithelium multiply and accumulate above the muscularis mucosae rapid lateral spread of the multiplying amebae (flask-shaped” ulcer) subsequent spread coalesce colonies of amebae enlargement of the necrotic area secondary intestinal lesions
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Extraintestinal infection (amebic hepatits or liver abscess) microemboli
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A B Figure 3: Endoscopic and histopathologic features of intestinal amebiasis. Source: Harrison’s Principles of Internal Medicine( 20th edition) page 1571
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CLINICAL SYNDROMES
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Intestinal Amebiasis asymptomatic cyst passage symptomatic amebic colitis fulminant intestinal infection Environmental enteropathy (“impoverished gut”; blunted smallintestinal villi with lamina propria inflammation
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Amebic Liver Abscess Febrile Right-upper quadrant pain Point tenderness over the liver and right-sided pleural effusion
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Complications of Amebic Liver Abscess Pleuropulmonary involvement Abscesses that rupture into the peritoneum Rupture into the pericardium
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Involvement of Other Extraintestinal Sites Genitourinary tract involvement Cerebral involvement
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DIAGNOSTIC TESTS
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Laboratory Diagnosis stool examinations serologic tests -Enzyme-linked immunosorbent assays, agar gel diffusion assays noninvasive imaging of the liver - ultrasonography, CT, and MRI
Slide 18-

Figure 4. E . hystolitica cyst Figure 5. E . hystolitica trophozoite Source: Jawetz, Melnick, & Adelberg’s Medical Microbiology (27th edition) page 710
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Figure 6. E . hystolitica trophozoite with ingested red blood cells
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TREATMENT
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Source: Harrison’s Principles of Internal Medicine( 20th edition) page 1573
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PREVENTION adequate sanitation eradication of cyst carriage