Amoebic Dysentery

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This is an acute parasitic infection of the colon that causes diarrhoea with blood and/or mucus.

Causes

  • Amoebiasis is caused by Entamoeba histolytica. Infection is through contaminated food and/or drink. 

Signs and symptoms

  • Diarrhoea
  • Abdominal pain, especially before and during passing of stools
  • Fever
  • Lack of appetite
  • Blood and mucus in stool
  • In rare cases, liver abscess may occur

Differential diagnosis

  • Bacillary dysentery (shigellosis)
  • Other causes of bloody diarrhoea

Investigations

  • Stool microscopy for motile organisms
  • Abdominal ultrasound scan
  • Colonoscopy with colonic biopsy

Treatment objectives

  • Ensure adequate hydration
  • Eradicate infecting organism

Pharmacological treatment

Correct dehydration (see section on rehydration)

Metronidazole oral

Adult:

800mg orally three times a day for 10 days.

Child:

10mg/kg orally in three divided doses daily

OR

Tinidazole oral

Adult:

2G daily for 3-5 days

Child:

> 3 years:  50mg/kg daily (up to 2 g per day) for 3 to 5 days

 

Asymptomatic cyst carriers

Treat using:

Diloxanide Furoate oral

Adult:

500mg three times a day for 10 days

Child:

> 25kg:  20 mg/kg/day orally in 3 divided doses

Prevention

  • Frequent hand washing with soap and clean water
  • Proper human waste disposal
  • Drink clean water