Indigenous amebiasis in hypoendemic area: myth or reality?
Abstract number: P743
Ivanova M., Nedzvedz M., Poljakova S., Saridze E., Fedorovich S., Glod E.
Amebiasis is one of the three most common causes of death from parasitic disease. Belarus is considered a non-endemic country since indigenous transmission of the Entamoeba histolytica parasite may be virtually non-existent. However, invasive intestinal and extra-intestinal infections have also been found among Belarusian population.
Objectives and Methods: The medical records of in-patients, who had been diagnosed as cases of amebiasis, at some hospitals in Minsk in 19942006, were retrospectively reviewed. This grope consist of 24 patients, 13 females and 11 males, average patient age was 56.4 years (range 2281 years). To avoid overdiagnosis in each case, amebiasis was confirmed by the identification of hematophagous trophozoites of Entamoeba histolytica by microscopic examination of stool, pus and tissue intravital and postmortem. Unfortunately, this is the only test available in Belarus now. According to outcomes of disease there were 16 dead patients and 8 recovered ones.
Results: The epidemic investigation shows that only 2 patients have visited endemic amebic countries. All fatal cases were misdiagnosed, before the deaths following clinical diagnoses were made: liver abscess, acute gangrenous cholecystitis (2), tumour of brain, Crohn's disease (2), intestinal tuberculosis, pulmonary tuberculosis, cancer of colon (4), mesenteric thrombosis, acute anaemia, sepsis (2). Pathologic investigations reveal various amebic intestinal damages: terminal enteritis (1), ascendant colitis (1), sigmoiditis (4), total colitis (3); extraintestinal damages: liver (7), gall bladder (3), pancreas (1), lungs (2), brain (3). All of patients were burdened of premorbid conditions (diabetes mellitus, cancer, chronic diseases of lungs, GIT, heart).
In the group of survived patients, there were 6 cases of liver amebic abscess, 1 case of complicated amebic sigmoiditis and 1 case of amebic colitis with ulcerative colitis.
Conclusions: Amebiasis can be indigenous in the former hypoendemic countries and can has very severe fatal forms. It is necessary to improve clinical diagnostic and parasitological methods, to perform an antigen detection using ELISA to provide a more reliable comment on the epidemiological pattern and clinical impact of the disease.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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