Amoebiasis-Clinical Features

Intestinal Amoebiasis

Clinical Presentation- Intestinal Amoebiasis:

Incubation Period is 2-6 weeks.

Abdominal pain and tenderness in the lower abdomen,painful sudden bowel evacuation(tenesmus) with recto-sigmoid involvement and diarrhoea developing over a period of one to several weeks.

In mild to moderate colitis,patient has mucus diarrhoea,but no blood in stool.

Patients with severe colitis pass offensive and bulky stools containing blood and mucus and have fever and lower abdominal cramps.

Gross pathology of intestinal amebiasis showing extensive ulceration

Physical findings: Hepatomegaly Localised tenderness Rales,rhonchi Localised intercostal tenderness Jaundice Epigastric tenderness

Diffuse liver tenderness is elicited,i.e tenderness on antero-posterior compression of the lower part of the chest on the right side.

A localised area of maximum tenderness must be looked for. This area may lie subcostally; if not, it is often found by thumb pressure in the intercostal space.One of the cardinal signs of liver abscess.

Elicited by palpating with the tips of the fingers all over the hepatic area including the right lower chest (anterior and posterior and subcostal area. As against intercostal tenderness which could be present in pleurisy etc., point tenderness is more diagnostic of liver abscess and is also a useful guide as to the side for abscess puncture. Point tenderness and intercostal tenderness are often elicited even in the absence of diffuse liver tenderness. The former is often elicited in the postero-lateral area of a lower right intercostal space

. Amoebic Liver abscess

Gross pathology of amebic abscess of liver. Tube of "chocolate" pus from

abscess.

This patient presented with a case of invasive extraintestinal amebiasis affecting the cutaneous region of the right flank causing severe tissue necrosis. Here we see the site of tissue distruction, pre-debridement.The wound then be covered by autologous skin grafts.

Intestinal Amoebiasis Extra-Intestinal Amoebiasis

Asymptomatic infection(cyst passers)

Non-suppurative amoebic hepatitis

Acute amoebic dysentery Amoebic liver abscess

Intestinal amoebiasis complicated by-

Amoebic liver abscess complicated by-

•Toxic megacolon •Empyema

•Fulminant amoebic colitis •Pericarditis

•Amoeboma •Peritonitis

•Amoebic peritonitis •Pulmonary amoebiasis

•Perianal ulceration •Cerebral amoebiasis

•Post-dysenteric colitis •Genitourinary amoebiasis

Cutaneous Amoebiasis

I guess it’s upto us to take care

of business.