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TM: Protozoa (i) (Entamoeba histolytica 1 (liver abscess (rapid onset of…
TM: Protozoa (i)
Entamoeba histolytica 1
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dysentry + extracolonic disease (e.g. amoebic liver abscess - liquid cystic cavity seen on CT, purulent, RUQ pain, pleuritic pain)
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life cycle
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- non-invasive colonisation
- intestinal + extra-intestinal disease (ectopic - liver, skin, brain)
- cysts + trophozoites passed in faeces
hence hygiene, sanitation, pit latrines NB
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almost any tissue can be affect - commonly liver, intestinal mucosa, brain, skin
causes goblet cells to over secrete + deplete themselves of mucin, leaving them vulnerable to infection
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intestinal features
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tenesmus (recurrent/continual inclination to evacuate bowels due to ulcerated rectum, pain inside anus upon passing stool) in 50%
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rarely perforation, severe bleeding from blood vessel, inflamm polyposis
fulminant colitis may develop (similar to IBD i.e. UC/Crohn's - important to excl infection before dxing these)
weightloss, fever, mild hepatomegaly
amoeboma may develop
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inflamm, lymphocytes, macrophages
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liver abscess
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thin-walled, necrotic centre with thick fluid (chocolate syrup, anchovy paste)
parasites detected in faeces 50% of time, or 75% if stool cultured
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dDx: acute surgical abdo, pyogenic liver abscess. right lower lobe pneumonia
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amoebae intro
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endolimax nana
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occurs in humans, primates, pigs
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