Entamoeba histolytica as a cause of chronic diarrhea

Authors

  • Andreia Alves de Castro Unidade de Saúde Familiar Amora Saudável. Amora, Portugal https://orcid.org/0000-0003-4438-6796
  • Filipe Bacalhau Unidade de Saúde Familiar Amora Saudável. Amora, Portugal
  • Francisco Ferreira e Silva Unidade de Saúde Familiar Amora Saudável. Amora, Portugal
  • Catarina Avillez Unidade de Saúde Familiar Amora Saudável. Amora, Portugal
  • João Batalheiro Unidade de Saúde Familiar Amora Saudável. Amora, Portugal

DOI:

https://doi.org/10.5712/rbmfc14(41)1917

Keywords:

Diarrhea, Entamoeba histolytica, Dysentery, Amebic, Public Health

Abstract

Chronic diarrhea, characterized by the presence of more than three loose stools for at least four weeks, is often found in clinical practice. In chronic diarrhea, the probability of an infectious etiology is low, having usually a functional, inflammatory, osmotic or secretory origin. Intestinal amebiasis is a cause of chronic diarrhea, caused by the protozoan Entamoeba histolytica, common and prevalent in developing countries. It can have different presentations but most patients are asymptomatic. We present a 27-year-old Caucasian male, man who have sex with men (MSM), with chronic diarrhea starting six years ago. The physical exam was normal. A parasitological stool examination was performed with isolation of cysts of Entamoeba histolytica. He was treated with metronidazole and paromomycin with clinical resolution. It is important for General Practice to address this etiology in the investigation of patients with diarrhea for a correct and timely diagnosis and treatment, to avoid unnecessary testing, possible complications, transmission of the agent and a serious public health problem.

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References

Fine KD, Schiller LR. AGA technical review on the evaluation and management of chronic diarrhea. Gastroenterology. 1999;116(6):1464-86. DOI: https://doi.org/10.1016/S0016-5085(99)70513-5

Camilleri M, Sellin JH, Barrett KE. Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea. Gastroenterology. 2017;152(3):515-532.e2. DOI: https://doi.org/10.1053/j.gastro.2016.10.014

Shirley DT, Farr L, Watanabe K, Moonah S. A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis. Open Forum Infect Dis. 2018;5(7):ofy161. DOI: https://doi.org/10.1093/ofid/ofy161

Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J. Laboratory diagnostic techniques for Entamoeba species. Clin Microbiol Rev. 2007;20(3):511-32. https://doi.org/10.1128/CMR.00004-07 DOI: https://doi.org/10.1128/CMR.00004-07

Pineda E, Perdomo D. Entamoeba histolytica under Oxidative Stress: What Countermeasure Mechanisms Are in Place? Cells. 2017;6(4).pii:E44. DOI: https://doi.org/10.3390/cells6040044

Marques FC, Sanches B, Guerreiro A, Nunes F, Azeredo P. Abcesso hepático amebiano em idade pediátrica - um caminho do intestino ao fígado. GE Port J Gastroenterol. 2014;21(5):208-11. https://doi.org/10.1016/j.jpg.2014.06.004 DOI: https://doi.org/10.1016/j.jpg.2014.06.004

Dhawan VK. Amebiasis. 2018. [acesso 2018 Nov 7]. Disponível em: https://emedicine.medscape.com/article/212029-overview#a2

Quintela C, Saiote J, Bettencourt MJ, Marques AD. Rectorragias como forma de apresentação de amebíase. Rev Port Coloproct. 2010;7(3):136-9.

Santos RV, Nunes Jda S, Camargo JA, Rocha EM, Fontes G, Camargo LM. High occurrence of Entamoeba histolytica in the municipalities of Ariquemes and Monte Negro, State of Rondônia, Western Amazonia, Brazil. Rev Inst Med Trop Sao Paulo. 2013;55(3):193-6. https://doi.org/10.1590/S0036-46652013000300010 DOI: https://doi.org/10.1590/S0036-46652013000300010

Lo YC, Ji DD, Hung CC. Prevalent and incident HIV diagnoses among Entamoeba histolytica-infected adult males: a changing epidemiology associated with sexual transmission--Taiwan, 2006-2013. PLoS Negl Trop Dis. 2014;8(10):e3222. DOI: https://doi.org/10.1371/journal.pntd.0003222

Hooshyar H, Rostamkhani P, Rezaian M. Molecular epidemiology of human intestinal amoebas in Iran. Iran J Public Health. 2012;41(9):10-7.

Tanyuksel M, Petri WA Jr. Laboratory diagnosis of amebiasis. Clin Microbiol Rev. 2003;16(4):713-29. https://doi.org/10.1128/CMR.16.4.713-729.2003 DOI: https://doi.org/10.1128/CMR.16.4.713-729.2003

Villarreal MR. File:Entamoeba histolytica life cycle-en.svg. Wikimedia Commons. 2008. [acesso 2018 Nov 6]. Disponível em: https://commons.m.wikimedia.org/wiki/File:Entamoeba_histolytica_life_cycle-en.svg

Samie A, Obi LC, Bessong PO, Stroup S, Houpt E, Guerrant RL. Prevalence and species distribution of E. Histolytica and E. Dispar in the Venda region, Limpopo, South Africa. Am J Trop Med Hyg. 2006;75(3):565-71. https://doi.org/10.4269/ajtmh.2006.75.565 DOI: https://doi.org/10.4269/ajtmh.2006.75.565

Parija SC, Mandal J, Ponnambath DK. Laboratory methods of identification of Entamoeba histolytica and its differentiation from look-alike Entamoeba spp. Trop Parasitol. 2014;4(2):90-5. https://doi.org/10.4103/2229-5070.138535 DOI: https://doi.org/10.4103/2229-5070.138535

Addib O, Ziglam H, Conlong P. Invasive amoebiasis complicating inflammatory bowel disease. Libyan J Med. 2007;2(4):214-5. https://doi.org/10.4176/070905 DOI: https://doi.org/10.4176/070905

Rayan HZ. Microscopic overdiagnosis of intestinal amoebiasis. Egypt Soc Parasitol. 2005;35(3):941-51.

Hung CC, Chang SY, Ji DD. Entamoeba histolytica infection in men who have sex with men. Lancet Infect Dis. 2012;12(9):729-36. https://doi.org/10.1016/S1473-3099(12)70147-0 DOI: https://doi.org/10.1016/S1473-3099(12)70147-0

Pickering LK. Amebiasis. In: Pickering LK, Baker CJ, Kimberlin DW, eds; AAP Committee on Infectious Diseases. 2012 Red Book: Report of the Committee on Infectious Diseases. 29 ed. Elk Grove Village: American Academy of Pediatrics; 2012. p. 222-5.

Abdolrasouli A, McMillan A, Ackers JP. Sexual transmission of intestinal parasites in men who have sex with men. Sex Health. 2009;6(3):185-94. https://doi.org/10.1071/SH08084 DOI: https://doi.org/10.1071/SH08084

Published

2019-04-08

How to Cite

1.
Castro AA de, Bacalhau F, Silva FF e, Avillez C, Batalheiro J. Entamoeba histolytica as a cause of chronic diarrhea. Rev Bras Med Fam Comunidade [Internet]. 2019 Apr. 8 [cited 2024 Jul. 3];14(41):1917. Available from: https://rbmfc.org.br/rbmfc/article/view/1917

Issue

Section

Clinical Cases

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