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Entamoeba histolytica
was first described by Lambl in 1859 and Losch established it pathogenic nature in 1875 in a dysenteric patient is St.Petersberg Councilman and lafleur in 1981 described amoebic liver abscess. Schauudinn ( 1903 ) differentiated pathogenic and nonpathogenic types of Amoebae
Amebiasis
Amebiasis (am-e-BI-a-
sis) is a disease caused by a one-celled parasite called Entamoeba histolytica (ent-a-ME-ba his-to-LIti-ka). Although it is more common in people who live in tropical areas with poor sanitary conditions
70.000 kematian per tahun di seluruh dunia Gejala-gejala dapat berkisar dari diare ringan untuk disentri dengan darah dan lendir pada tinja. E. histolytica biasanya merupakan organisme commensals. Infeksi Amoebiasis parah (dikenal sebagai invasive atau fulminan amoebiasis) terjadi dalam dua bentuk utama. Invasi menyebabkan lapisan usus disentri amuba atau kolitis amuba.
Trends of Amoebiasis
Transmission of Amebiasis
Amoebiasis is
transmitted by fecal contamination of drinking water and foods, but also by direct contact with dirty hands or objects as well as by sexual contact. Additionally, geophagy is a common route of infection in certain cultures.
Sifat penyakit
Gejala biasanya gastrointestinal termasuk
diare, muntah, sakit perut atau ketidaknyamanan dan demam. Gejala memakan waktu dari beberapa hari sampai beberapa minggu untuk mengembangkan dan mewujudkan diri mereka sendiri, tetapi biasanya itu adalah sekitar dua sampai empat minggu. Sebagian besar orang yang terinfeksi tidak menunjukkan gejala, tetapi penyakit ini memiliki potensi untuk membuat penderita sakit berbahaya, terutama jika ada saran immunocompromised.
Events on Amoebiasis
Trophozoites of E.histolytica
structure (Trophozoites) has one basophilic nuclei about the size of RBCs. Note some RBC's are phagocytosed by the Trophozoites (erythrophagocytos is)
Faktor virulensi
Trophozoites dari E.histolytica berinteraksi dengan host melalui serangkaian langkah Target 1 Adhesi sel, fagositosis dan efek cytopathic 2 E.histolytica menginduksi baik humoral dan respon imun diperantarai sel. 3 Faktor virulensi - Dalam beberapa keadaan lumen tinggal Amoeba mungkin asimtomatik 4 Penyebab penyakit hanya ketika menyerbu Usus 5 virulensi berhubungan dengan sekresi Sisteina proteniase yang membantu dalam mencerna organisme ekstraselular matriks dan menyerang jaringan
Sisteina proteinase yang dihasilkan oleh strain invasif E.histolytica inactivates faktor komplemen C3 dan dengan demikian tahan terhadap lisis komplemen yang diperantarai.
Sistein proteinase
adalah faktor virulen penting E.histolytica is resistant to complement mediated lysis matriks ekstraselular struktural dan menurunkan fibronectin dan laminin, serta tipe I kolagen.
Dapat memecah
infection 1 Stress 2 Malnutrition 3 Alcoholism 4 Corticosteriod therapy 5 Immunodeficiency 6 Alternation of Bacterial flora
Risk Factors
People in developing countries that have poor
sanitary conditions Immigrants from developing countries Travellers to developing countries People who live in institutions that have poor sanitary conditions HIV-positive patients Men who have sex with men
Dysentery
No symptoms (in
the majority of cases), Vague gastrointestinal distress, Dysentery (with blood and mucus).
symptoms or none. More severe infection may cause fever, profuse diarrhea, abdominal pain, jaundice, anorexia, and weight loss. In severe cases, it can lead to development of abscesses (pockets of amoebae and inflammatory cells) in the liver or, more rarely, the brain.
("luminal amebiasis"), to invasive intestinal amebiasis (dysentery, colitis, appendicitis, toxic mega colon, amebomas), to invasive extra intestinal amebiasis (liver abscess, peritonitis, pleuropulmonary abscess, cutaneous and genital amoebic lesions).
Diagnosis of Amebiasis
Diagnosis of amebiasis can be very
difficult. One problem is that other parasites and cells can look very similar to E. histolytica when seen under a microscope. Therefore, sometimes people are told that they are infected with E. histolytica even though they are not. Entamoeba histolytica and another ameba, Entamoeba dispar, which is about 10 times more common, look the same when seen under a microscope
Microscopy
Ini adalah cara tradisional
mendiagnosa penyakit ini. E. histolytica hanya tampak pada sampel di bawah mikroskop. Karena E. histolytica tidak selalu ditemukan di setiap tinja sampel, beberapa sampel dari hari yang berbeda mungkin diperlukan. Kadang-kadang sel-sel darah merah yang telah ditelan oleh parasit yang terlihat.
E. Histolytica cyst.
Trophozoites pseudopodia dan mengandung selsel darah merah yang ditemukan dalam jumlah besar. Endoplasm tampak kebiruan dan inti tidak terlihat, tetapi samar garis besar dapat dilihat
obtained from Liver, lung, or Brain biopsy samples and subjected to routine Histopathology ( H&E) sections Giemsa stained touch preparations which will revel Trophozoites in extra intestinal lesions.
abscess appear as red Anchovy sauce like appearance The material aspirated is likely to contain Trophozoites and may be detected by direct microscopic examination
Serological Diagnosis
The serological become reactive in invasive
Amoebiasis 1 Indirect Heamagglutination assay ( IHA ) 2 ELISA 3 Latex agglutination test 4 gel diffusion 5 Counter current Imunoelectrphoresis
Culture
Cultures are not done routinely Boeck and Drbohlavs medium modified by
Laidlaw extensively used for isolation and maintenance of E.histolytica. Diamonds axenic medium used in studies on Pathogenicty, antigenic characterization and drug sensitivity tests
mendapatkan amuba tumbuh di luar tubuh sangat sulit dan tidak bisa diandalkan, dan karena itu tidak umumnya dilakukan
Immunity in Amoebiasis
Infection with
invasive strains of E.histolytica induce both Humoral and cellular response. Infection offers some degree of protection.
infeksi, sistem kekebalan tubuh menciptakan antibodi untuk melawannya. Ini dapat dideteksi dengan tes darah, dan memberikan bukti bahwa seseorang telah terinfeksi dengan E. histolytica. Sayangnya, tes ini tidak membedakan antara infeksi masa lalu dan masa kini
the most useful tests for detecting E. histolytica. They test directly for the parasite itself by exposing some stool to a strip of paper coated with antibodies. The parasites will stick to the antibodies on the paper. The test distinguishes E. histolytica from other parasites.
Treating Amebiasis.
Sering, baik metronidazole (flagyl) atau
tinidazole (Fasigyn) digunakan untuk mengobati Amebiasis. Jika ini tidak berhasil, chloroquine, emetine, dan dehydroemetine dapat digunakan. Menghilangkan kista yang tidak memiliki gejala dicapai dengan diloxanide furoate (Furamide), iodoquinol (Yodoxin), dan paromomycin. Nitazoxanide adalah obat yang lebih baru yang menunjukkan bukan hanya janji terhadap E. histolytica, tetapi
Preventing Amoebiasis
Drink only bottled or boiled (for 1 minute) water, or
carbonated (bubbly) drinks in cans or bottles. Fountain drinks and any drinks with ice cubes are not safe. Water can be made safe by filtering it through an "absolute 1 micron or less" filter and dissolving iodine tablets in the filtered water. Hindari buah-buahan segar atau sayuran yang dikupas oleh orang lain. Avoid milk, cheese, or dairy products that may not have been pasteurized. Avoid anything sold by street vendors.
Food safety
Thoroughly cook all raw
foods. * Thoroughly wash raw vegetables and fruits before eating. * Reheat food until the internal temperature of the food reaches at least 167 Fahrenheit. Wash your hands before preparing food, before eating, after going to the toilet or changing diapers, after smoking or after using a tissue or handkerchief.
Personal Hygiene
Wash hands thoroughly
with soap and hot running water for at least 10 seconds after using the toilet or changing a baby's diaper. Clean bathrooms and toilets often. Pay particular attention to toilet seats and taps. Avoid sharing towels or face washers.