Aim. The aim of this paper is to review clinical-epidemiological features and diagnostics of imported amebiasis and to attract clinicians’ attention to rare travellers’ infection.
Review of the literature. Amebiasis is the disease caused by unicellular parasite Entamoeba histolytica. Intection spreads by faecal-oral route or by ingestion contaminated food and water, especially drinks with ice. Many species belong to Entamoeba genus, but only E. histolytica is pathogenic to human. Amebiasis is widespread all over the world but in developed countries is most common in travellers’ returning from endemic areas. Not more than 60 cases of E. coli infection and till 10 cases of E. histolytica imported invasion are diagnosed in Lithuania per year. Infections range from asymptomatic colonization to amebic colitis and extraintestine amebic abscesses (liver amoebic abscesses). Amoebic colitis starts gradually, diarrhoea with blood can occur, faeces looks like “raspberries jelly”. Patiens complains abdominal pain, discomfort when defecating, travel to endemic areas is mostly documented. Amebic liver abscess may present acutely or subacutely, travel to endemic zones can be documented within a year period. Patient indicates fever, general weakness, right upper abdominal tenderness and pain. Amebiasis is treated with luminal (paromomycin, iodoquinol, diloxanidefuroate) and tissue (metronidazole, tinidazole) amebicids.
Case series. We analyzed amebiasis cases diagnosed within 2008-2017 year in VUH IDT and SK IDC. 9 of them were liver abscesses and 14 involved large bowel. Most of the patients had history of travel to endemic zone (India, Thailand, Tanzania). Disease symptoms manifested from few days till 1.5 Mo after the travel.
Conclusion. It is important to find out epidemiological anamnesis and include amebiasis in differential diagnosis when consulting patients with diarrhoea or liver abscess. When amebiasis is suspected, specific diagnostic tests should be done (such as fresh stool microscopy, parasite detection with concentrated stool method, E. histolytica antigen detection in stool, serum specific antibody tests).
