- Amebic Dysentery
Amebic Dysentery shows Loose motions: 6 to 8 times, semisolid, copious, dark red in color, with mucus and blood. It has got offensive smell. Along with this the child may have low grade fever, abdominal cramps and tenesmus.
Matured infected cysts are swallowed along with contaminated food or water. These cysts reach to cecum and excystation occurs in cecum. Each cyst liberates tetranucleated ameba which eventually form eight amoebulae by binary fission. These amoebulae grow in size and invade the mucosa of large intestine. This can give rise to acute amebic dysentery in which large number of trophozoite forms are discharged in infected stool. If host resistance is good it may not produce any symptom and cystic forms are discharged in stool and thus the life cycle continues. From the intestine the trophozoite may get portal entry and extra intestinal organs like liver, lungs and brain may get affected. Mode of Transmission 1. Fecal contamination of drinking water: Due to improper water supply and faulty drainage system. In many urban areas with unauthorized housing constructions, there is hardly any distance between drinking water storage tank and sewage tank, thus contamination of drinking water is quite common in such areas. 2. Food handling by carriers of the disease: Mother may act as source of infection for amebic dysentery in the child. 3. Hotel employees may also transmit the disease to large population. 4. Eating uncooked, raw vegetables and fruits. 5. Housefly can also spread the infection by passing from infected feces to unprotected food articles.
Signs of Amebic Dysentery
Mild to moderate tenderness in cecum and rectosigmoidal area. The abdomen may be distended.
Though this disease is commonly observed in slightly older children can affect infants also. Trophozoites are also observed in stool of children around six months. Extra intestinal spread of the disease is rare and the child will have symptoms and signs related to the affected organ. For example, amebic liver abscess may have pain and tenderness in Rt hypochondrium.
Investigations of Amebic Dysentery
Stool Examinations for amebic dysentery : Microscopic examination will show (i) Plenty of RBCS in clumps; (ii) Pus cells and macrophages are few; (iii) Trophozoites or cystic form of E. histolytic may be seen. Amebiasis involving other organs like liver, lungs and brain require specialized investigations and hospitalization.
Differential Diagnosis for Amebic Dysentery
Other causes of loose motions in children-
1. Bacillary Dysentery: 10-15 small semisolid stools per day. May be contaminated with mucus and bright red blood. Microscopic examination RBCS few: Bright red in color b. Numerous pus cells and mac- rophages a,
2. Giardiasis: Discussed on P 135.
3. Viral infection causing loose motion: Watery motions. Stool examination may not show any abnormal finding.
4. Lactose intolerance: Due to infective diarrhea lasting for longer duration. Stool examination will show reducing substance positive.
5. Drug induced diarrhea: Drugs like Ampicillin, Cephalosporin can induce loose motion.
6. Chronic diarrhea: Consultants opinion can be taken for diagnosing and managing such cases.
Treatment of Amebic Dysentery
1. Treatment of acute attack
2. Prevention of recurrence
Treatment of Acute Amebic Dysentery
Following drugs can be used in treating amebic dysentery.
Metronidazole, Diloxanide furoate, Tinidazole, and Inj. Dehydroemetine.
The drug which is commonly used is Syr. Metronidazole 25 to 40 mg/kg/ day in 3 divided doses for 7 to 10 days. Usually combination of Metronidazole and Diloxanide furoate or combination of Tinidazole and Diloxanide Furoate is preferred for chronic and acute cases. Dose of Diloxanide furoate 20 mg/ kg/ day in 3 divided doses for 7 to 10 days.
In severe cases Inj. Dehydroemetine is used in a dose of 0.5 mg/kg IM once in a day. Use this drug with caution. Dehydration because of amebic dys- entery is uncommon and rarely child requires intra venous fluids to correct the dehydration. Amebiasis involving other organs: Such patient should be hospitalized for further management.
Prevention of Amebic Dysentery and Advice for parents-
1. To give boiled water to the child
2. To avoid outside eatables.
3. Treatment of adult family members if they have similar symptoms.
4. Clean India Campaign
NOTE–Do not follow any treatment And medicine provided here ,please consult your nearest hospital or health care and talk to your doctor.This artical is only for knowledge purpose.
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