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Analysis of the Epithelial Damage Produced by Entamoeba histolytica Infection
Published on: June 12, 2014
Nontravel-related invasive Entamoeba histolytica infection with probable heterosexual transmission
Sofia R de Valdoleiros1, João Abranches Carvalho2, Celina Gonçalves1
1Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal.
Introduction:
In industrialized countries, amebiasis usually occurs in migrants and travelers returning from areas where the disease is endemic, primarily by ingestion of contaminated food or water. Person-to-person transmission can occur, mainly by fecal-oral contact, but sexual transmission has also been described [1,[3], [4], [5]].
Presentation Of Case:
We report a man with Entamoeba histolytica colitis and a large liver abscess (16.5 × 14 cm) in Portugal, who had no relevant travel history and whose only risk factor was his heterosexual partner. The abscess required drainage of 1950 mL of "chocolate-milk" purulent fluid, with rapid symptomatic improvement. The diagnosis was established by real-time reverse transcription PCR for Entamoeba histolytica in the liver aspirate, with positive IgG antibodies. He received a total of 16 days of ceftriaxone and metronidazole followed by 7 days of paromomycin.
Conclusion:
As enteric infections may be sexually transmitted, in industrialized countries, even in the absence of travel, sexual history should not be neglected.
Insights
Amebiasis, a parasitic infection, can spread through sexual contact, even in non-endemic areas. Healthcare providers should consider sexual history in diagnosing amebiasis, especially in industrialized countries without a travel history.
Area of Science:
- Infectious Diseases
- Hepatology
- Public Health
Background:
- Amebiasis is typically acquired through ingestion of contaminated food or water, common in endemic regions.
- In industrialized nations, cases often involve travelers returning from endemic areas or migrants.
- Sexual transmission of enteric infections, including amebiasis, is increasingly recognized.
Observation:
- A case of amebiasis presenting as colitis and a large liver abscess in Portugal is described.
- The patient had no relevant travel history, with a heterosexual partner identified as the sole risk factor.
- Diagnosis was confirmed via PCR on liver aspirate and serology, with successful treatment involving antibiotics and abscess drainage.
Findings:
- Entamoeba histolytica infection can manifest as severe liver abscesses.
- Sexual transmission is a potential route for amebiasis in industrialized countries, irrespective of travel history.
- Prompt diagnosis and treatment, including abscess drainage and antimicrobial therapy, are crucial for patient recovery.
Implications:
- Physicians should include sexual history in the patient's medical evaluation for amebiasis, particularly in non-endemic settings.
- This case highlights the importance of considering non-traditional transmission routes for parasitic infections.
- Public health strategies may need to address sexual transmission of amebiasis in industrialized countries.
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