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Life-Cycle of Entamoeba Histolytica

The document describes the life cycle of Entamoeba histolytica. Quadrinucleated cysts contaminate food and water and excyst in the small and large intestine. Metacyclic forms invade the intestinal lumen and undergo binary fission, invading tissues and spreading laterally to cause flask-shaped ulcers in the cecum and ascending colon. The last generation of trophozoites encyst and are passed in feces, continuing the environmental contamination cycle.

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110 views

Life-Cycle of Entamoeba Histolytica

The document describes the life cycle of Entamoeba histolytica. Quadrinucleated cysts contaminate food and water and excyst in the small and large intestine. Metacyclic forms invade the intestinal lumen and undergo binary fission, invading tissues and spreading laterally to cause flask-shaped ulcers in the cecum and ascending colon. The last generation of trophozoites encyst and are passed in feces, continuing the environmental contamination cycle.

Uploaded by

sonata38
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Life-Cycle of Entamoeba histolytica

Quadrinucleated cysts
(Infective stages)

Contamination of food & H2O

Excystation in Small / large Intestine

4 Metacyclic Forms (Amoebules)


Life-Cycle of Entamoeba histolytica
Amoebules in Intestinal lumen

Binary Fission 8 Amoebae

Invade intestinal tissues (Trophozoites)

Asexual reproduction by binary fission


(Colonies of Amoebae:Increase in Population)
Life-Cycle of Entamoeba histolytica
Asexual reproduction by binary fission
( Increase in Population)

Last generation before encystment:Precystic stage


Trophozoites Round up, Expel food particles

Encystment & Cysts in lumen

Cysts in faeces Environmental contamination


(Soil/Ground) (PP : Man- 4days;Dogs-8-10Days)
Pathogenesis of E. histolytica
Attributed to Invasive nature
Invasion of tissues : (?)
 Secretion of proteolytic enzymes

 Phosphohydrolase

 Viruses : Icosahedral & Filamentous

 Bacteria
Pathogenesis of E. histolytica
Invasion of Intestinal mucosa

Multiply asexually: Binary fission

Invasion in deeper layers (Submucosa)

Spread laterally

Flask shaped ulcers:Caecum & Ascending Colon


Pathogenesis of E. histolytica
Pathogenesis of E. histolytica
Flask Shaped Ulcers in Colon
Pathogenesis of E. histolytica
Invasion in intestinal mucosa/submucosa

Spread to other organs via circulation

Right lobe of liver via portal circulation

Trapped in interlobular venules

Lytic necrosis Hepatic Amoebic Abscess


Other organs : Lungs & Brain
Hepatic Amoebic Abscess
Pathogenesis of E. histolytica
Chronology : Sequence of events

Noninvasive colonization in Int. lumen

Invasion in Int. mucosa / submucosa


( Flask shaped ulcers)

Extraintestinal invasion: Liver/Lung/Brain


Pathogenesis of E. histolytica
in Animals ( Dogs & Cats)
 Dogs :Natural infections
 Source: Man
 Intestinal Disease : Caecum

 Cats : Highly susceptible


 Acute Disease : Ulcerative lesions
 Organisms Fail to encyst
 Cat Borne Infection ?
Clinical Signs of Amoebic Dysentery
 Influenced by severity of infection
: Acute Amoebiosis :
Severe dysentery Dehydration
(Anorexia)
Blood & Mucus in faeces
Intense griping pain,frequently visits latrines
straining blood & mucus

Prolapse of rectum
Clinical Signs of Amoebic Dysentery
 Chronic Amoebiosis :
 Recurrent GI symptoms Viz.
 Diarrhoea or Dysentery
 Abdominal Pain (Abdominal discomfort)
 Nausea
 Flatulence
 Anorexia
Clinical Signs of Amoebic Dysentery
Extra intestinal Phase
 Liver : Pain on right side of abdomen
Enlarged tender liver
Fever, Vomiting, Anorexia.

 Lungs : Chest Pain & Respiratory Distress.

 CNS : Epilepsy & Nervous signs.


Epidemiology of Amoebiosis.
 Zooanthroponosis
 Ubiquitous : Common in tropical &
subtropical countries
 India; Densely populated cities
 Delhi- 20%; Kolkata- 24%;
Mumbai- 27% & Chennai-37%.
(Survey 1972)
Epidemiology of Amoebiosis
 Longevity of Cysts
 Tetranucleated cysts: Infective stages
 Survive for two weeks in wet surrounding.
 No effect of water chlorination- viable for
several weeks
 Very susceptible to desiccation
 Thermal death point – 500C
Epidemiology of Amoebiosis
 Other Vital Factors :
 Flies

 Vegetables

 Food Handlers

 Faulty Plumbing (Metropolitan Cities)


Epidemiology of Amoebiosis
 Human & Cats suffer more severely
 Human Beings : Travelers disease
 Complete elimination is difficult &
relapses are common
 Cats : Organisms do not encyst
Diagnosis of Amoebiosis
 Intestinal Disease
 Stool Sample Examination

 Demonstration of cysts (tetranucleated).


 Differential diagnosis(1% Lugols Iodine)
 Trophozoites in loose stools.
 Immunodiagnosis: Invasive disease
Diagnosis of Amoebiosis
 Intestinal Disease: SSE : Cysts

 DD : Entamoeba coli
Diagnosis of Amoebiosis
 Extraintestinal Disease:
 Immunodiagnosis

 Radiology

 MRI

 CT scan
Diagnosis of Amoebiosis

 Extraintestinal Disease:
Treatment of Amoebiosis
 Intestinal Disease:
 Metronidazole: Drug of choice.
 Acute : 800mg tid for 5 days.
 Chronic : 400mg tid for 5 days.
Treatment of Amoebiosis
 Extraintestinal disease:
 Tinidazole- 200mg bid - 5 days.
 Chloroquine: 150 mg bid - 10 days.
 Diloxanide furoate-500mg tid-10 days.
 Di-iodohydroxyquinoline-600mg bid-21
days
 Supportive : Gut acting antibiotics
Anticoagulants, Astringents.
Control of Amoebiosis

 Good Sanitation.

 Proper sewage system.

 Avoidance of contamination of food & H 2O.

 Health Education & Personal Hygiene.

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