AMOEBIASIS

• Amoebiasis


  Protozoal infection that initially involves the colon but may spread into the liver and lungs by lymphatic dissemination
• Etiologic Agent


  Entamoeba Histolytica
• Stages of Entamoeba Histolytica

  • Cyst
  • Trophozoites / vegetative form
• Cyst


  • Considered to be the infective stage and the resistance to environmental conditions and can survive for few days outside the body
• Trophozoites / vegetative form


  • Facultative parasites that invades the tissue
• Source of Infection


  • Contaminated food and water
  • Flies
• Mode of Transmission


  • Fecal-oral
  • Oral-anal
• Incubation Period


  Severe infections: 3 days<|>Average 2-4 weeks
• Period of Communicability


  Communicable for the entire duration of the illness or until cysts are present in the stool
• Clinical Manifestation - Acute Amoebic Dysentery


  • Slight attack of diarrhea altered with PD of constipation
  • Watery foul-smelling stools containing blood streaked mucus
  • Gaseous distension of the lower abdomen
  • Nausea, flatulence
  • Tenderness in the right iliac region
• Clinical Manifestation - Chronic Amoebic Dysentery

  • Diarrhea for several days, succeeded by constipation
  • Anorexia, weight loss, weakness, fatigue
  • Watery, bloody mucoid stool
  • Flatulence and irregular bowel movement
  • Abdomen loses its elasticity
  • Severe cases - scattered ulceration is seen through sigmoidoscopy
• Diagnostic Procedures


  • Stool exams - cyst (plenty of amoeba on the stool)
  • Blood exams - leukocytosis
  • Sigmoidoscopy
• Management


  • Metronidazole (Flagyl) 800mg TID x 5 days
  • Tetracycline, Ampicillin, Streptomycin, Chloramphenicol
• Nursing Interventions


  • Observe isolation and enteric precautions
  • Proper collection of stool specimen
  • No oil prep for 48 hours
  • Large portion of stools containing blood mucus
  • Label specimen properly
  • Send specimen immediately to the laboratory
  • Provide skin care and hygiene
  • Provide optimum comfort dysenteric patient should never be allowed to feel cold
  • Diet fluid should be forced
  • Cereals and strained meat broths without fats
  • Bland diet without cellulose or bulk producing foods
  • Chicken and fish may be added when convalescence is established
• Prevention


  • Health education and Fly control
  • Sanitary disposal of feces
  • Safe drinking water
  • Proper food preparation and food handling
  • Detection and treatment of carriers