Case Report: Lower Gastrointestinal Bleeding due to Entamoeba histolytica Detected Early by Multiplex PCR: Case Report and Review of the Laboratory Diagnosis of Amebiasis

Madden, Gregory R; Shirley, Debbie-Ann; Townsend, Gregory C.; Moonah, Shannon

doi:10.4269/ajtmh.19-0237

Cited by 9 publications

(10 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In developed countries like Spain, amebiasis infection is seen in migrants and travelers returning from endemic areas, or in high-risk groups, which include people who have oral-anal sexual practices and immunocompromised populations. In developed countries, sexual contact has also emerged as an important risk factor for transmission [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Host factors such as genetic susceptibility, immune status, young age, pregnancy, corticosteroid therapy, malnutrition, and alcohol abuse have been described as risk factors in the dissemination and severity of amebiasis [ 4 , 7 ]. A sex difference in amoebic infection has also been documented, with more invasive disease in males; for example, over 80% of amebic liver abscesses occur in adult men [ 7 ]. Our patient was a young man with a history of alcoholism and malnutrition; these factors probably favored a greater invasiveness of the amebic disease.…”

Section: Discussionmentioning

confidence: 99%

“…Extracted and purified DNA samples were stored at 4ºC until molecular processing. Detection of Entamoeba histolytica DNA was performed by real-time PCR (RT-PCT), targeting a sequence of the SSU rRNA gene [ 7 ]. The RT-PCR technique allowed the detection of E. histolytica in a sample of liver aspirate.…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

An Unexpected Case of Disseminated Amebiasis with Cerebral Involvement and Successful Recovery in a Non-Endemic Context

et al. 2021

View full text Add to dashboard Cite

Patient: Male, 39-year-old Final Diagnosis: Amebiasis Symptoms: Temperature of 38ºC • abdomial pain and diarrhea Medication: — Clinical Procedure: — Specialty: Critical Care Medicine Objective: Unusual clinical course Background: Amebiasis is a parasitic infection caused by the protozoan Entamoeba histolytica . Amebic brain abscesses are a rare form of invasive amebiasis frequently lethal due to the difficulty of its diagnosis and inadequate treatment. Cerebral amebiasis poses a therapeutic challenge as evidenced by the scarcity of papers reporting complete recovering after treatment. Case Report: We report the case of a 39-year-old Spanish man, with a history of alcohol and drug abuse. He had never traveled outside of Europe, no reported oral-anal sexual contact, and no history of immunosuppressant medication. He was admitted to the Emergency department with temperature of 38°C, abdominal pain, and diarrhea. An abdominal CT scan showed multiples abscesses in the liver. Therefore, empirical meropenem treatment was started on suspicion of pyogenic liver abscesses due to lack of epidemiological risk factors for parasitic infection. In the liver aspirate samples, E. histolytica trophozoites were directly visualized and a real-time PCR was also positive for it. After amebiasis diagnosis, intravenous (IV) metronidazole therapy was initiated. During his admission, the patient developed pulmonary, cutaneous and cerebral involvement amebiasis. The management of amebic brain abscesses includes surgical drainage and antiparasitic treatment, in our case IV metronidazole was maintained for 10 weeks. No surgical treatment was performed and even so, the patient evolved favorably. Conclusions: Amebic brain abscesses have a high mortality rate if inadequate treatment. A timely diagnosis and suitable treat can reduce its mortality, so the diagnosis of amebic infection should not be precluded in non-endemic countries.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Unexpected Case of Disseminated Amebiasis with Cerebral Involvement and Successful Recovery in a Non-Endemic Context

et al. 2021

View full text Add to dashboard Cite

show abstract

“…[ 30 ] and Madden et al . [ 31 ]). However, there are neither standardized PCR protocols nor commercially available detection kits, resulting in varying degrees of sensitivity and specificity of the often applied in-house protocols [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

et al. 2020

View full text Add to dashboard Cite

Background Infection with Entamoeba histolytica and associated complications are relatively rare in developed countries. The overall low prevalence in the Western world as well as the possibly prolonged latency period between infection with the causing pathogen and onset of clinical symptoms may delay diagnosis of and adequate treatment for amoebiasis. Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of invasive amoebiasis. Pregnancy has been described as a risk factor for development of invasive amoebiasis and management of these patients is especially complex. Case presentation A 30-year-old Caucasian woman in early pregnancy presented to our emergency department with abdominal pain alongside elevated inflammatory markers and liver function tests. Travel history revealed multiple journeys to tropic and subtropic regions during the past decade and a prolonged episode of intermittently bloody diarrhea during a five month stay in Indonesia seven years prior to admission. Sonographic and magnetic resonance imaging revealed a 5 × 4 cm hepatic abscess. After ultrasound-guided transcutaneous liver drainage, both abscess fluids and blood cultures showed neither bacterial growth nor microscopic signs of parasitic disease. Serological testing confirmed an infection with Entamoeba histolytica, which was treated with metronidazole, followed by eradication therapy with paromomycin. Subsequent clinical, laboratory and imaging follow-up exams showed regression of the ALA. In addition, the pregnancy completed without complications and a healthy baby boy was born 7 months after termination of treatment. Conclusions This case of invasive amoebiasis in early pregnancy outside of endemic regions and several years after exposure demonstrates the importance of broad differential diagnostics in the context of liver abscesses. The complex interdisciplinary decisions regarding the choice of imaging techniques as well as interventional and antibiotic therapy in the context of pregnancy are discussed. Furthermore, we present possible explanations for pregnancy as a risk factor for an invasive course of amoebiasis.

show abstract

“…Multiple areas across the world continue to observe prevalence rates of amebiasis of over 10% [14]. Commonly considered an infection of poor countries spread by fecaloral transmission, however, immigration, travel, and sexual transmission are leading to reemergence of amebiasis in developed settings [16][17][18][19][20][21][22][23][24][25]. There is no vaccine and only one class of drugs (nitroimidazoles) available to effectively treat invasive forms of disease.…”

Section: Introductionmentioning

confidence: 99%

COP9 signalosome is an essential and druggable parasite target that regulates protein degradation

et al. 2020

Self Cite

View full text Add to dashboard Cite

Understanding how the protozoan protein degradation pathway is regulated could uncover new parasite biology for drug discovery. We found the COP9 signalosome (CSN) conserved in multiple pathogens such as Leishmania, Trypanosoma, Toxoplasma, and used the severe diarrhea-causing Entamoeba histolytica to study its function in medically significant protozoa. We show that CSN is an essential upstream regulator of parasite protein degradation. Genetic disruption of E. histolytica CSN by two distinct approaches inhibited cell proliferation and viability. Both CSN5 knockdown and dominant negative mutation trapped cullin in a neddylated state, disrupting UPS activity and protein degradation. In addition, zinc ditiocarb (ZnDTC), a main metabolite of the inexpensive FDA-approved globally-available drug disulfiram, was active against parasites acting in a COP9-dependent manner. ZnDTC, given as disulfiram-zinc, had oral efficacy in clearing parasites in vivo. Our findings provide insights into the regulation of parasite protein degradation, and supports the significant therapeutic potential of COP9 inhibition.

show abstract

Case Report: Lower Gastrointestinal Bleeding due to Entamoeba histolytica Detected Early by Multiplex PCR: Case Report and Review of the Laboratory Diagnosis of Amebiasis

Cited by 9 publications

References 30 publications

An Unexpected Case of Disseminated Amebiasis with Cerebral Involvement and Successful Recovery in a Non-Endemic Context

An Unexpected Case of Disseminated Amebiasis with Cerebral Involvement and Successful Recovery in a Non-Endemic Context

Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report

COP9 signalosome is an essential and druggable parasite target that regulates protein degradation

Contact Info

Product

Resources

About