Symptoms

Acute: Frequent dysentery with necrotic mucosa and abdominal pain.

Chronic: Recurrent episodes of dysentery with blood and mucus in the feces. There are intervening gastrointestinal disturbances and constipation. Cysts are found in the stool. The organism may invade the liver, lung and brain where it produces abscesses that result in liver dysfunction, pneumonitis, and encephalitis.

Pathology
Intestinal ulcers (craters/flasks - figure 4) are due to enzymatic degradation of tissue. The infection may result in appendicitis, perforation, stricture granuloma, pseudo-polyps, liver abscess (figure 4); sometimes brain, lung and spleen abscesses can also occur. Strictures and pseudo-polyps result from the host inflammatory response.

Immunology
There is an antibody response after invasive infection (liver abscess or colitis) but it is of questionable significance in immunity, as there is recurrence of enteric episodes in these patients.

Diagnosis
Symptoms, history and epidemiology are the keys to diagnosis. In the laboratory, the infection is confirmed by finding cysts in the stool (Figure 1). E. histolytica infection is distinguished from bacillary dysentery by the lack of high fever and absence PMN leukocytosis.

Distinction must be made from other non-pathogenic intestinal protozoa (e.g., Entamoeba coli, Entamoeba hartmanni, Dientamoeba fragilis, Endolimax nana, Iodamoeba buetschlii, etc.). (Figure 5)

Treatment
Iodoquinol is used to treat asymptomatic infections and metronidazole is used for symptomatic and chronic amebiasis, including extra-intestinal disease.

Acute: Frequent dysentery with necrotic mucosa and abdominal pain.

Chronic: Recurrent episodes of dysentery with blood and mucus in the feces. There are intervening gastrointestinal disturbances and constipation. Cysts are found in the stool. The organism may invade the liver, lung and brain where it produces abscesses that result in liver dysfunction, pneumonitis, and encephalitis.

Pathology
Intestinal ulcers (craters/flasks - figure 4) are due to enzymatic degradation of tissue. The infection may result in appendicitis, perforation, stricture granuloma, pseudo-polyps, liver abscess (figure 4); sometimes brain, lung and spleen abscesses can also occur. Strictures and pseudo-polyps result from the host inflammatory response.

Immunology
There is an antibody response after invasive infection (liver abscess or colitis) but it is of questionable significance in immunity, as there is recurrence of enteric episodes in these patients.

Diagnosis
Symptoms, history and epidemiology are the keys to diagnosis. In the laboratory, the infection is confirmed by finding cysts in the stool (Figure 1). E. histolytica infection is distinguished from bacillary dysentery by the lack of high fever and absence PMN leukocytosis.

Distinction must be made from other non-pathogenic intestinal protozoa (e.g., Entamoeba coli, Entamoeba hartmanni, Dientamoeba fragilis, Endolimax nana, Iodamoeba buetschlii, etc.). (Figure 5)

Treatment
Iodoquinol is used to treat asymptomatic infections and metronidazole is used for symptomatic and chronic amebiasis, including extra-intestinal disease.

from : http://pathmicro.med.sc.edu