Amebic dysentery; Intestinal amebiasis
Amebiasis is an infection of the intestines caused by the parasite Entamoeba histolytica.
Entamoeba histolytica can live in the large intestine (colon) without causing damage to the intestine. In some cases, it invades the colon wall, causing colitis, acute dysentery, or long-term (chronic) diarrhea. The infection can also spread through the blood to the liver. In rare cases, it can spread to the lungs, brain, or other organs.
This condition occurs worldwide. It is most common in tropical areas that have crowded living conditions and poor sanitation. Africa, Mexico, parts of South America, and India have major health problems due to this disease.
Entamoeba histolytica is spread through food or water contaminated with stools. This contamination is common when human waste is used as fertilizer. It can also be spread from person to person, particularly by contact with the mouth or rectal area of an infected person.
Risk factors for severe amebiasis include:
In the United States, amebiasis is most common among those who live in institutions or people who have traveled to an area where amebiasis is common.
Most people with this infection do not have symptoms. If symptoms occur, they are seen 7 to 28 days after being exposed to the parasite.
Severe symptoms may include:
The health care provider will perform a physical exam. You will be asked about your medical history, especially if you have recently traveled overseas.
Examination of the abdomen may show liver enlargement or tenderness in the abdomen.
Tests that may be ordered include:
Treatment depends on how severe the infection is. Usually, antibiotics are prescribed.
If you are vomiting, you may need to receive medicines through a vein (intravenously) until you can take them by mouth. Medicines to stop diarrhea are usually not prescribed, because they can make the condition worse.
After antibiotic treatment, your stool will likely be rechecked to make sure the infection has been cleared.
Outcome is usually good with treatment. Usually, the illness lasts about 2 weeks, but it can come back if you do not get treated.
Call your health care provider if you have diarrhea that does not go away or gets worse.
When traveling in countries where sanitation is poor, drink purified or boiled water. Do not eat uncooked vegetables or unpeeled fruit.
Huston CD. Intestinal protozoa. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 109.
Petri WA Jr, Haque R. Entamoeba species, including amebic colitis and liver abscess. In: Bennett JE, Dolin R, Mandell GL, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 274.
Review Date: 8/31/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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