AMEBIASIS

General Information

DEFINITION--Parasitic infection of the large intestine and sometimes the liver. Amebiasis is most prevalent in developing countries. In the USA, the disease is relatively rare in the general population but is concentrated in some high-risk groups. Many people, especially those who live in temperate climates, harbor the amoeba without symptoms. Symptoms occur when the parasite invades tissues of the colon. Symptoms may be very vague.

BODY PARTS INVOLVED--Intestinal tract, especially the colon; liver.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Sometimes no symptoms are present. Intermittent diarrhea with bad-smelling stools. Diarrhea is often preceded by constipation in early stages. Gas and abdominal bloating. Abdominal cramps and tenderness. Fever. Mucus and blood in the stool (sometimes). Fatigue and muscle aches. If the liver is involved:

• Tenderness over the liver and right side of the abdomen.
• Jaundice (sometimes).

CAUSES--

A microscopic parasite that is spread by flies, cockroaches and direct contact with hands or food contaminated with feces. The most common sources of infection are:

• Infected food handlers.
• Faulty hotel or factory plumbing.
• Raw vegetables or fruit fertilized with human feces or washed in polluted water.

RISK INCREASES WITH

• Crowded or unsanitary living conditions.
• Travel to a foreign country.
• Combination of anal-oral sex.
• Institutional living.

> Wash your hands frequently--

always before eating.

• If you are in an area where food or water may be contaminated, the following measures are necessary: Boil drinking water for 5 minutes. Don't use water for any purpose that may have raw sewage. Don't eat unpeeled fruit or vegetables and raw fish or shellfish.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of stool and blood serum; sigmoidoscopy (See Glossary); x-rays of lower bowel (barium enema).

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment.
• Hospitalization (severe cases only).

POSSIBLE COMPLICATIONS

• Peritonitis.
• Hepatitis or liver abscess.
• Lung abscess.
• Infection of the pericardium.
• Brain abscess.

PROBABLE OUTCOME--In most cases without complications, amebiasis is curable in 3 weeks with treatment. In the carrier state, this disease may not cause any symptoms. In severe cases, it may cause dysentery that requires hospital treatment.

How To Treat

GENERAL MEASURES----Be extra careful about personal cleanliness. Bathe frequently and wash hands with warm water and soap after each bowel movement and before handling food.

MEDICATION--Your doctor may prescribe antiamoeba medication. Fluid replacement may be necessary to manage electrolyte imbalance due to diarrhea.

ACTIVITY--Rest in bed during an acute attack. Resume normal activities when fever disappears and diarrhea improves.

DIET--Soft diet progressing to normal diet. (See Soft Diet in Appendix.)

Call Your Doctor If

• You have symptoms of amebiasis.
• The following occur during treatment: Abdominal cramps continue longer than 24 hours. Diarrhea or blood in stool increases. Vomiting begins. Pain begins over liver or jaundice occurs. A skin rash appears. Irritability or a severe headache develop.