Canadian Health&Care; Mall

Discussion Amebiasis, caused by Entamoeba histolytica, is endemic in many areas of the world including south and southeastern Asia, South Africa, Mexico and even some areas of the United States. Occasionally amebiasis is diagnosed in patients in nonendemic areas because of their recent travels. The cyst form, mainly transmitted by contaminated water and food, develops into the trophozoite stage in the intestine. The host may remain asymptomatic but may pass cysts or the disease may invade the bowel causing a dysentery syndrome. Spread of the disease to the liver leads to abscess formation. Although the liver is primarily involved, the lung is the second most commonly involved organ; the brain and spleen are rarely involved. Pleuropulmonary complications occur in 7 to 20 percent of patients with amebic liver abscesses and in 2 to 3 percent of those with invasive disease. Presentation ranges from minimal clinical abnormality to an overwhelming illness with respiratory failure, sepsis and shock. The patients often have a chronic illness with weight loss and fatigue. At times there is a history of the presence of symptoms years before the diagnosis is made.^ Diarrhea rarely brings the patients with pleuropulmonary involvement to the hospital, although a history of diarrhea may be elicited. Cough is the most common respiratory symptom, but dyspnea and hemoptysis are frequent. Signs of consolidation or effusion may occur along with lower thoracic and right upper quadrant pain.