Prevalence of amebiasis in inflammatory bowel disease in University Clinical Hospital Mostar

Babić, Emil; Bevanda, Milenko; Mimica, Mladen; Karin, Maja; Volarić, Mile; Bogut, Ante; Barišić, Tatjana; Pravdić, Danijel; Šutalo, Nikica

doi:10.1186/s40064-016-3261-7

Cited by 14 publications

(17 citation statements)

References 13 publications

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“…Invasive amoebae infections show a greater prevalence in patients with IBD when compared to the general population. This suggests that empirical anti-amoebic therapy should be recommended in cases of persistent or relapsing IBD, especially in endemic areas [20,21].…”

Section: Discussionmentioning

confidence: 99%

Approach to amoebic colitis: Epidemiological, clinical and diagnostic considerations in a non-endemic context (Barcelona, 2007-2017)

et al. 2019

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Background Amoebic colitis is the most frequent clinical manifestation of invasive intestinal infection due to Entamoeba histolytica and a common cause of diarrhoea worldwide. Since higher transmission rates are usually related to poor health and exposure to unhygienic conditions, cases reported in Europe usually involve immigrants and international travellers. The goal of this study was to characterise both the clinical and the epidemiological features of a European population diagnosed with amoebic colitis and then to evaluate the diagnostic tools and therapeutic options applied. Methods and results This was a retrospective observational study in which data from all patients diagnosed with amoebic colitis attending at the International Health Units of two tertiary referral hospitals, Germans Trias i Pujol University Hospital (Badalona, North Barcelona Metropolitan Area) and Vall d’Hebron University Hospital (Barcelona city) between 2007 and 2017 were analysed. During the study period 50 patients were diagnosed with amoebic colitis. Thirty-six (72%) were men, and immigrants accounted for 46% of all cases. Antecedents of any international travel were reported for 28 (56%), the most frequent destinations having been the Indian subcontinent, South and Central America and sub-Saharan Africa. Preexisting pathological conditions or any kind of immunosuppression were identified in 29 (58%) patients; of these, 13 (26%) had HIV infection—all of them men who have sex with men—and 5 (10%) had inflammatory bowel disease. Diarrhoea, abdominal pain and dysentery were the most frequently recorded symptoms of invasive amoebae. Diagnosis was made through microbiological study in 45 (90%) and/or histological identification of amoebae in colon biopsies in 10 (20%). After treatment with metronidazole (82%) or tinidazole (8%), all patients had good outcomes. Post-acute intraluminal treatment was indicated in 28 (56%). Conclusions Amoebic colitis should be suspected in patients with diarrhoea and compatible epidemiological risk factors (immigration, travelling abroad or men who have sex with men), especially if some degree of immunosuppression concurs. These risk factors must be taken into account in any diagnostic approach to inflammatory bowel disease (IBD), and active searches for stool parasites should be performed in such cases to rule out misdiagnosis or simultaneous amoebic infection. Treatment should include intraluminal anti-amoebic treatment in order to avoid relapse and prevent further spread of the disease.

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Section: Discussionmentioning

confidence: 99%

Approach to amoebic colitis: Epidemiological, clinical and diagnostic considerations in a non-endemic context (Barcelona, 2007-2017)

et al. 2019

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“…Patients with Crohn's disease are at risk for pyogenic liver abscess due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses [ 15 ]. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population [ 16 ]; however, a higher incidence of amebic liver abscesses has not been reported. Our patient was likely predisposed to such an amebic abscess due to a combination of his travel history and immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Abscess in a Returning Traveler with Crohn’s Disease: Differentiating Amebic from Pyogenic Liver Abscess

Gaut

Shull

Bejjani

et al. 2018

Case Reports in Medicine

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Liver abscess is a rare but serious complication of Crohn's disease. Patients with Crohn's disease are at risk for pyogenic liver abscesses due to immunosuppressive therapy, fistulous disease, and intraabdominal abscesses. Inflammatory bowel disease patients are also known to have a greater prevalence of amebiasis compared to the rest of the population; however, a higher incidence of amebic liver abscess has not been reported. We describe a case of a liver abscess in a patient with Crohn's disease that was initially presumed pyogenic but later determined to be amebic in origin. Epidemiology, clinical presentation, diagnosis, and treatment of amebic and pyogenic liver abscesses are discussed.

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“…Other complications include acute fulminant necrotizing amoebic colitis, toxic megacolon, toxic myocarditis, right iliac fossa mass, and acute appendicitis [47,[79][80][81][82]. Recent work also suggests increased co-infection rates of entamoeba with concomitant pulmonary tuberculosis [83], as well as a greater prevalence of rates of infection in patients with inflammatory bowel disease (Crohn's disease or ulcerative colitis), compared with the general population [84].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: a public health problem

et al. 2020

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Entamoeba histolytica (E. histolytica) is a facultative protozoan parasite implicated in amoebic liver abscesses (ALA), the most common extraintestinal manifestation of this infection. E. histolytica is endemic to subtropical and tropical countries and has been a major public health concern in northern Sri Lanka (SLK) for the last three decades. This has been attributed to a multitude of factors such as poor sanitation, hygiene, male sex, middle age, overcrowding, unsanitary practices in the production of indigenous alcoholic beverages, and alcohol consumption. Additionally, while rates of E. histolytica have declined substantially throughout the rest of the island, largely due to better infrastructure, it remains pervasive in the northern peninsula, which is generally less developed. Infection arises primarily from fecal-oral transmission through the consumption of contaminated drinking water containing cysts. Upon ingestion, cysts multiply into trophozoites and colonize the host colonic mucosa using lectin and cysteine proteases as virulence factors, leading to host invasion. Symptoms occur along a spectrum, from asymptomatology, to pyrexia, abdominal cramping, and amoebic dysentery. Colonization of the colon results in the formation of distinct flask-shaped ulcers along the epithelium, and eventual penetration of the lamina propria via the production of matrix metalloproteinases. ALA then develops through trophozoite migration via the mesenteric hepatic portal circulation, where microabscesses coalesce to form a single, large right-lobe abscess, commonly on the posterior aspect. The progression of infection to invasive disease is contingent on the unique interplay between host and pathogen factors, such as the strength of host-immunity to overcome infection and inherent pathogenicity of the Entamoeba species. As a preventable illness, E. histolytica complications such as ALA impose a significant burden on the healthcare system. This mini-review highlights epidemiological trends, risk factors, diagnostic modalities, treatment approaches, and opportunities for prevention of E. histolytica-induced ALA, to help address this endemic problem on the island of SLK.

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Prevalence of amebiasis in inflammatory bowel disease in University Clinical Hospital Mostar

Cited by 14 publications

References 13 publications

Approach to amoebic colitis: Epidemiological, clinical and diagnostic considerations in a non-endemic context (Barcelona, 2007-2017)

Approach to amoebic colitis: Epidemiological, clinical and diagnostic considerations in a non-endemic context (Barcelona, 2007-2017)

Hepatic Abscess in a Returning Traveler with Crohn’s Disease: Differentiating Amebic from Pyogenic Liver Abscess

Entamoeba histolytica and amoebic liver abscess in northern Sri Lanka: a public health problem

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