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Protozoal gastroenteritis - Coggle Diagram
Protozoal gastroenteritis
aetiology
giardia Iablia
Cryptosporidium parvum
Entamoeba histolytica
Entamoeba
general
90% asymptomatic
amoebic dystentry
extra-intestinal disease
liver abscess
returning travellers
8-20wks
RUQ pain
may radiate
shoulder
swinging fever
diarrhoea
hepatomegaly
Dx
imaging
US, CT, MRI
70-80% single lesions
usually right lobe
serology
antigen detection
aspirate
anchovy paste
red-ish brown
trophozoites on microscopy
worldwide
highest burden
developing countries
developed countries
migrants from endemic areas
travellers to endemic areas
Life cycle
forms
cysts
ingested in contaminated food/water
trophozoite
in small intestine from excystation
travel to large intestine
invade and penetrate colonic mucosa
tissue destruction
bloody diarrhoea
invasive infection
e.g through portal venous system
liver abscess
increased intestinal secretion
forms cysts
exit in stool
clinical features
subacute onset
1-3wks
diarrhoea
usually bloody
abd. pain
weight loss
fever
Dx
stool microscopy
detection of cysts/trophozoites
not uniformly distributed
3 samples from separate days
antigen detection
stool
serum
serology
pos
won't know if acute/past inf
Tx
oral metronidazole
paromomycin
eradication of intraluminal cysts
liver abscess
risk of rupture
may require aspiration