Microbiology Department, Kasturba Medical College, Manipal, India.
Braz J Infect Dis. 2010 Jul-Aug;14(4):372-3.
Infections with Entamoeba histolytica are seen worldwide and are more prevalent in the tropics. About 90% of infections are asymptomatic, and the remaining 10% produce a spectrum of clinical syndromes, ranging from dysentery to abscesses of the liver or other organs. Extra-intestinal infection by E. histolytica most often involves liver. Pleuro-pulmonary involvement, seen as the second most common extra-intestinal pattern of infection, is frequently associated with amebic liver abscess. Pulmonary amebiasis occurs in about 2-3% of patients with invasive amebiasis. We report herein the case of a 45-year-old male presenting with hepato-pulmonary amebiasis. The diagnosis was established from direct examination of sputum, in which trophozoites of E. histolytica were detected, and by serology. Following treatment with metronidazole and chloroquine, the clinical evolution improved significantly. On regular follow-up visits, the patient was asymptomatic. This case report reiterates the need for collaboration between clinicians and microbiologists for timely diagnosis of such infections.
全世界都有溶组织内阿米巴感染,在热带地区更为常见。约 90%的感染无症状,其余 10%产生一系列临床综合征,从痢疾到肝脓肿或其他器官脓肿。溶组织内阿米巴的肠外感染最常累及肝脏。浆膜-肺部感染,是感染的第二常见肠外模式,常与肝脓肿有关。肺阿米巴病发生在侵袭性阿米巴病患者的 2-3%左右。我们在此报告一例 45 岁男性肝肺阿米巴病。通过直接检查痰液中发现溶组织内阿米巴滋养体和血清学检测来确诊。经过甲硝唑和氯喹治疗,临床情况明显改善。定期随访时,患者无症状。本病例报告再次强调了临床医生和微生物学家之间需要合作,以便及时诊断此类感染。