Voldřich M, Novotný P, Tyll T, Rudiš J, Belšan T, Hedlová D, Stefanová M
Epidemiol Mikrobiol Imunol. 2014 Sep;63(3):226-31.
This comprehensive review is focused on a serious protozoan disease, amebiasis. This disease is caused by the human parasite Entamoeba histolytica (E. histolytica), the second leading cause of mortality due to protozoan disease worldwide (the leading cause is malaria). The incidence of amebiasis in the Czech Republic is very low, but it may be underreported as the disease often escapes diagnosis. Intestinal colonisation by E. histolytica may be asymptomatic. The clinical picture ranges from diarrhea to colitis or fulminant colitis when the parasite progresses to the trophozoite stage. Secondary dissemination in the blood or lymph system may induce systemic signs of the disease. Liver abscess is the most common extraintestinal form of amebiasis. The diagnosis of intestinal amebiasis is based on the clinical picture and parasitological examination of the stool. To diagnose extraintestinal amebiasis, serology tests are used to detect antibodies in the blood. Recently, molecular methods have been increasingly used for the detection of the nucleic acids of the pathogen in biological specimens. The first line therapy for amebiasis are 5-nitroimidazole drugs, currently available in the Czech Republic. However, surgical intervention should also be considered in patients with a severe course of the disease. Included in the review are the case reports of patients with severe concomitant intestinal and extraintestinal amebiasis.
这篇综述聚焦于一种严重的原生动物疾病——阿米巴病。该疾病由人体寄生虫溶组织内阿米巴(E. histolytica)引起,是全球原生动物疾病致死的第二大原因(首要原因是疟疾)。在捷克共和国,阿米巴病的发病率很低,但可能存在漏报情况,因为这种疾病常常难以诊断。溶组织内阿米巴在肠道内定植可能没有症状。当寄生虫发展到滋养体阶段时,临床表现从腹泻到结肠炎或暴发性结肠炎不等。在血液或淋巴系统中的继发性播散可能引发该疾病的全身症状。肝脓肿是阿米巴病最常见的肠外表现形式。肠道阿米巴病的诊断基于临床表现和粪便的寄生虫学检查。为了诊断肠外阿米巴病,血清学检测用于检测血液中的抗体。最近,分子方法越来越多地用于检测生物标本中病原体的核酸。阿米巴病的一线治疗药物是5-硝基咪唑类药物,目前在捷克共和国有此类药物。然而,对于病情严重的患者也应考虑手术干预。综述中还包括患有严重的肠道和肠外阿米巴病合并症患者的病例报告。