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Tropical Colorectal Surgery
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Meheshinder Singh, Kemal I. Deen
This represents the mildest form of invasive disease. Even though small ulcers may be found in the colon in such patients, they do not have bowel symptoms. However, these patients are at risk of developing an amoebic liver abscess, or of progressing at a later stage to acute amoebic dysentery. Serum antibodies are usually present in such patients.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Amoebic dysentery is transmitted through contaminated food and water sources and is caused by the amoeba Entamoeba histolytica. Patients can present with frequent, loose, and bloodstained stools; weight loss; dehydration; indigestion; colic abdominal pain; and rectal bleeding. The most frequent sites of infection are the caecum, ascending colon, and sigmoid colon. The amoebae affect the underlying mucosa causing inflammation and ulceration.
Entamoeba histolytica
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Jesús Serrano-Luna, Moisés Martínez-Castillo, Nidia Leon-Sicairos, Mineko Shibayama, Mireya de la Garza
Most individuals infected with E. histolytica present no symptoms. Approximately 4%–10% of these individuals develop the disease over a year,62,63 experiencing bloody diarrhea and abdominal pain,64,65 with several weeks of symptoms. Small-volume mucoid stools and watery diarrhea are common. As amoebae invade the colonic mucosa, stools are haem-positive.64 Fever is not typical (<40% of patients); weight loss and anorexia can be present.64,65 Rarely, patients develop fulminant amoebic dysentery with profuse bloody diarrhea, fever, pronounced leukocytosis, and severe abdominal pain.65–67 Pregnant women, immunocompromised individuals, and patients receiving corticosteroids are especially at risk of contracting fulminant IA; associations with diabetes and alcohol abuse have also been reported.68
Introduction to the special issue on gastroenterology
Published in Paediatrics and International Child Health, 2019
Kapula Chifunda and Paul Kelly describe important parasites associated with the gut, particularly their clinical manifestations and management. Giardia intestinalis (syn. G. lamblia) was the first parasite to be recognised under the microscope by van Leeumenhoek (in his own stool sample) in 1681. The trophozoite adheres to the enterocyte brush border which may be responsible for a mild enteropathy. Although patients with hypogammaglobulinaemia (including IgA deficiency) are at increased risk of chronic giardiasis, those with HIV infection are not and neither are children with Entamoeba histolytica infection. E. histolytica causes amoebic dysentery and amoebic abscess; however, it has to be differentiated from the non-pathogenic E. dispar which is identical microscopically and can only be distinguished from E. histolytica by molecular techniques. Cryptosporidium is responsible for outbreaks of diarrhoea and patients with HIV infection are vulnerable to severe disease. It is associated with growth failure, malnutrition and neurocognitive impairment. Soil-transmitted helminths are generally light, asymptomatic infections. Severe complications occur in Ascaris lumbricoides (obstruction of the gut, biliary or pancreatic ducts), hookworms (anaemia) and Trichuris trichuria (dysentery). One of the main strategies for preventing soil-transmitted helminths has been mass de-worming. A recent systematic Cochrane review did not support this practice.