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Analysis of the Epithelial Damage Produced by Entamoeba histolytica Infection
Published on: June 12, 2014
Amebic infection in humans
Gourdas Choudhuri1, Murali Rangan
1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India. choudhuri.gour@gmail.com
Abstract:
Clinical human infections with the protozoa Entamoeba histolytica is still estimated to occur in 50 million people worldwide, of which approximately 100,000 die annually. Although most clinical symptoms are due to involvement of the large intestine, 1 % present with involvement of the liver in the form of a liver abscess, a potentially fatal condition. Distinguishing an invasive form (E. histolytica) from a morphologically identical non-invasive one (E. dispar) requires molecular or enzymatic characterization. Further, the pattern of infection, interpretation of presence of antibodies in the host, manifestations of disease, approach to investigations and strategies for management remain complex. This article also provides a comprehensive review of the parasite and host factors that govern the complex relationship of the prozoa and humans, and tries to explain why some develop a particular form of the disease in endemic zones. Application of modern imaging and image guided therapy seems to be playing a major role in diagnosis and management of the potentially most serious form of the disease, amebic liver abscess. Despite lack of controlled studies there is a tendency to lower the threshold of their use in clinical practice, and indeed in-hospital mortality rate seems to be falling for amebic liver abscess. In a world getting increasingly swamped by non-infectious metabolic diseases, awareness of amebic infections, its bed-side diagnosis, the use of appropriate laboratory tests, and decision making in management are shrinking. This review tries to update the scientific developments in amebiasis.
Insights
Amebiasis, caused by Entamoeba histolytica, affects millions globally, leading to significant mortality. This review updates scientific developments in amebiasis, focusing on diagnosis and management of invasive forms like amebic liver abscess.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Tropical Medicine
Background:
- Amebiasis remains a significant global health concern, with Entamoeba histolytica causing millions of infections and substantial annual deaths.
- Distinguishing invasive Entamoeba histolytica from non-invasive Entamoeba dispar requires specialized diagnostics.
- Amebic liver abscess, a severe manifestation, complicates 1% of infections, posing a potentially fatal threat.
Purpose of the Study:
- To provide a comprehensive review of Entamoeba histolytica and Entamoeba dispar infections.
- To elucidate parasite and host factors influencing disease manifestation and severity.
- To update on modern diagnostic and therapeutic strategies for amebiasis, particularly amebic liver abscess.
Main Methods:
- Literature review of amebiasis, focusing on parasite biology, host-pathogen interactions, and clinical management.
- Analysis of the role of modern imaging and image-guided therapies in diagnosing and managing amebic liver abscess.
- Synthesis of current scientific developments and clinical practice guidelines.
Main Results:
- Invasive amebiasis, especially amebic liver abscess, requires accurate diagnosis using molecular or enzymatic methods.
- Modern imaging techniques and image-guided therapies are increasingly vital for managing amebic liver abscess.
- Despite challenges, in-hospital mortality for amebic liver abscess appears to be decreasing.
Conclusions:
- Accurate diagnosis and management of amebiasis, particularly invasive forms, are crucial despite declining awareness.
- Advances in imaging and interventional therapies are improving outcomes for amebic liver abscess.
- Continued research and updated clinical practices are essential to combat the global burden of amebiasis.
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