Amebiasis is both an acute and chronic cause of diarrheal disease caused by the protozoa Entamoeba hystolytica. It is transmitted by the faeco-oral route and infection is usually caused by ingestion of cysts from contaminated food and drink. Its manifestations vary from asymptomatic carrier state to severe fulminating illness with mucosal inflammation and ulceration. The diagnosis should also be considered when a patient with bloody diarrhoea fails to show improvement following treatment for shigellosis.

Diagnosis is made by identification of the RBC ingesting trophoizites by direct stool examination.

INTESTINAL AMOEBIASIS

Treatment

First line:

Metronidazole, 750 mg p.o. tid for 5-7 days. For children: 7.5 mg/kg p.o. tid, for 5 days.

S/E: metalic taste, nausea and vomiting;

C/I: epilepsy, hepatic malfunction, pregnancy, breast feeding and hematological disorders.

D/I: with disulfiram, confusion; with alcohol, disulfiram like reaction; with cimetidine, decreased metabolism; with phenobarbital, increased metabolism.

Dosage forms: Tablet, capsule, 250mg,; Oral suspension, 125 mg/5ml; Syrup, 4% W/V, 250mg/5ml; intravenous infusion, 5 mg/ml in 100 ml

OR

Tinidazole, 2g p.o. stat for 3 consecutive days. For children: 50-60 mg/kg daily for 3 days. (For S/E and C/I, see under metronidazole).

Dosage forms: tablet, 150 mg, and 500 mg

Alternative:

Metronidazole, 750 mg p.o. tid for 7 days. For children: 7.5 mg/kg p.o. tid for 5 days.(For S/E,C/I and dosage forms, see above)

OR

Tinidazole, 2g p.o. stat, for 3 consecutive days. For Children: 50-60 mg/kg daily for 3 days (For S/E, C/I and dosage forms, see page 1)

PLUS

Diloxanide furoate, 500 mg, tid for 10 days. For children over 25 kg, 20 mg/kg daily in 3 divided doses for 10 days.

S/E: flatulence, vomiting, urticaria, pruritis.

C/I: pregnancy.

Dosage forms: tablet, 500 mg