Amoebiasis And Giardia Flashcards
Where is amebiasis predominantly found?
India
West and South Africa
SE Asia
Latin America
How is amoeba spread?
Faecal-oral
Contaminated food and water
What is the only pathogenic amoeba?
Entamoeba Histolytica
Risk factors for amoebiasis?
Crowding
Lack of portable water
Institutionalised populations
Living in rural areas
MSM
What are some of the clinical presentations of intenstinal ameobiasis?
Acute amebic colitis: abdo pain, fever and weight loss, left lower quadrant pain
Fulminant colitis: severe often in immunocompromised and malnourished
What is colonisation of amoeba?
Non invasive amebiasis:
Haemoccult negative stool and normal colonoscopy
Get non specific GI complaints
What is an Ameboma?
Usually in elderly
Mass of granulation tissue with Peripheral fibrosis usually in caecum and ascending colon
What do you think of in a male with fecer, weight loss diarrhoea and hepatomegaly? Bloods show leukocytosis and raised ALP
Amebic liver abscess
What are some of the complications of amebic liver abscess?
Fear it will rupture and spread to pleura pericardium and abdomen
What does cutaneous amebiasis look like?
V rare
Ano gentian and personal ulcers with heaped up borders
How do you diagnose amebiasis?
Can identify cysts or trophozoites in stool, PCR is gold standard and will differentiate between species
When do you perform endoscopy?
If positive serum but negative stool
FLASK SHAPED ULCERS usually in caecum and ascending colon
When do you drain a liver abscess?
> 10cm
In left quadrant as risk of pericardial imbasion
Not responding to medical tx ie no resolution of fever within 4-5 days
Tx of colonisation of E Histolytica
Paromycin or Iodoquinol
Tx invasive E Histolytica
Metronidazole and Paromycin
Tx of liver abscess?
Metronidazole (10 days) or tinidazole (5days) and paromycin or diodoquinol
What other antibiotics are good in amebiasis?
Metronidazole or tinidazole or nitazoxanide
What are some of the luminal agents?
Paromycin or diiodohydroxyquin
Cyst vs trophozoites appearance?
Cysts typically have 1-4 nuclei
Trophozoite is typically a single nuclei that’s ingested a RBC
What do you think of a trophoozoite with a kidney shaped nuclei?
Balantidium Coli
Found in pigs, humans are incidental hosts- causes dysentery weight loss and colonic perforation
Tx with metronidazole or tetracyclines
Name some of the giardia species
Giardia Lamblia
Giardia Duodenalis
Giardia intestinalis
Symptoms of giardia?
Incubates for 1-2 weeks:
Prolonged diarrhoea, flatulence, bloating when it’s chronic get malabsorption of iron, vitamin A and B12
What do bloods show?
Completley normal, no eosinophilia
How is giardia spread?
Faecal Oral
Contaminated food/water
