Absceso esplénico amebiano / Amebic splenetic abscess

La localización extraintestinal es una complicación temible de la amebiasis intestinal, con una elevada mortalidad, que oscila entre el 4 al 14 por ciento de los casos diagnosticados. La forma de presentación más común es el absceso hepático amebiano, y aunque se han reportado localizaciones pulmonares, peritoneales, y hasta cerebrales, la localización esplénica es extremadamente infrecuente. Se reporta un caso de amebiasis esplénica que evolucionó tórpidamente, a pesar del tratamiento específico con metronidazol desde su admisión al Departamento de Emergencia, y que fue intervenido quirúrgicamente al séptimo día, con evolución favorable después de la resección del bazo. Se realiza una revisión de la literatura actualizada sobre el tema(AU)

The extraintestinal location is a fearsome complication of the intestinal amebiasis, with a high mortality fluctuating between the 4 and the 14 percent of cases diagnosed. The commonest presentation way is the amebic hepatic abscess and although others have reported pulmonary, peritoneal and up to cerebral locations, the splenetic one is extremely infrequent. A case of splenetic amebiasis is reported which evolved in a torpid way despite the specific treatment with metronidazole from its admission to Emergence Department and that was operated on at seventh day with a favorable evolution after spleen resection. Authors made a review of the updated literature on this subject(AU)

Colo-colic intussusception in amoebic colitis: a case report

Intussusception is a common cause of acute abdomen in the pediatric population. However, the condition is quite rare among adults. Intussusception among adults differs from the pediatric counterpart in having an underlying pathology, commonly neoplastic on most occasions. Pre-operative diagnosis is rarely established. Most cases. require surgical treatment. We present a case of colo-colic intussusception in an adult involving the transverse colon, which was precipitated by amebic colitis. The diagnosis was made by abdominal CT scan and the condition was effectively treated non-surgically by colonoscopic reduction

Bilateral Acanthamoeba ulcer in a user of disposable soft contact lenses: a tragic incident or a consequence of the aggressive policy of soft contact lens trading? / Úlcera bilateral por Acanthamoeba em usuária de lentes de contato gelatinosas descartáveis: um incidente trágico ou uma conseqüência da política agressiva de venda de lentes de contato gelatinosas?

This is the report of a case of bilateral Acanthamoeba keratitis in a 19-year-old woman who bought a pair of disposable soft contact lenses in a boutique. She wore this same pair of lenses for 3 months daily without the appropriate care. This led to bilateral corneal transplantation with cataract extraction and also trabeculectomy in the right eye. When last seen, both grafts were crystal clear but the visual acuities were far from satisfactory. She also had bilateral secondary glaucoma, barely controlled by topical medication. Actually, the physical features and the wearing time characteristics of the disposable soft contact lenses created unprecedented difficulties to the medical surveillance of their wearers. Without the right assistance they tend to become careless regarding routine cleaning. They also feel free to buy less expensive lenses, to use saline instead of lens solutions, to violate the limits of wearing time and to extend the use over the sleeping period. Additionally, the aggressive marketing and the wide distribution of these lenses increase the chances that economically or educationally unprepared people will acquire them. The question that remains is: Is the present case an accidental event or an example of what is likely to happen in the future if the indiscriminate selling of disposable soft contact lenses continues to evolve?

Este é o relato de uma paciente do sexo feminino, de 19 anos, com ceratite bilateral por Acanthamoeba, devido ao uso de lentes de contato descartáveis, adquiridas em uma butique. Fez uso do mesmo par de lentes durante três meses, sem os cuidados adequados. Foi submetida a transplante penetrante de córnea e facectomia bilateral, além de trabeculectomia no olho direito. Quando vista pela última vez, os enxertos estavam transparentes, mas a visão de ambos os olhos não era satisfatória. Ela também apresentava glaucoma secundário bilateral, controlado precariamente com medicação tópica. Ocorre que, as características físicas e o regime de uso das lentes de contato gelatinosas descartáveis criam dificuldades adicionais para a vigilância médica dos seus usuários. Sem a assistência correta, eles relaxam com a rotina de limpeza, compram lentes mais baratas, usam soro fisiológico ao invés das soluções adequadas, violam os limites de uso e dormem com as mesmas. Além disso, o "marketing" agressivo e a ampla distribuição dessas lentes aumentam as chances de que pessoas, não preparadas econômica e educacionalmente, venham ter acesso às mesmas. A pergunta que fica é: Seria o presente caso um evento acidental ou um exemplo do que pode acontecer no futuro caso as lentes de contato descartáveis continuem sendo vendidas indiscriminadamente?

Acanthamoebae presenting as primary meningoencephalitis in AIDS.

A rare case of Acanthamoebae meningoencephalitis is diagnosed in cerebrospinal fluid (CSF) of a 24 years old male suffering from acquired immunodeficiency syndrome (AIDS) patient on the basis of bright field microscopy and culture growth on non-nutrient agar with Escherichia coli. This case illustrates that Acanthamoebae should be considered in the differential diagnosis of meningoencephalitis in AIDS in addition to tuberculosis and cryptococcus infection in tropical areas.

Superior vena cava syndrome caused by pulmonary amoebic abscess.

Isolated pulmonary amoebiasis without involvement of liver and other systems is extremely rare. Its presentation with superior vena cava (SVC) syndrome is not well documented. The case of 38-year-old male who developed SVC syndrome due to a large pulmonary amoebic abscess, which initially mimicked a pulmonary neoplasm with distal lung abscess is presented here. Subsequent bacteriological examination of the aspirated pus and the sputum along with suggestive serology confirmed the diagnosis of pulmonary amoebic abscess.

Amphizoic amoebae: pathogenic free-living protozoa; review of the literature and review of cases in Thailand.

A large variety of species of free-living amoebae (FLA) caused an indefinite form of these protozoa. Non-fixed form, as indicated by amoeboid movement and possed the bacteria to survive in nature. Two species of pathogenic FLA: Naegleria fowleri and Acanthamoeba spp. were identified as the causative agents of Primary Amoebic Meningoencephalitis (PAM) and Granulomatous Amoebic Encephalitis (GAE) respectively. They were suggested to amphizoic protozoa, capable of living as parasites or as free-living and they were also considered to be distributed worldwide. These amoebae were detected in lakes, rivers and ponds. The first case of meningoencephalitis was observed in 1961 by Fowler Many cases were reported later on and the pathogenicity was tested by nasal inoculation of mice. In fact, quite a number of FLA were isolated but only a few species were pathogenic to humans. The three typical features which allow recognition of Naegleria spp. flagellate stage, round cyst and promitotic trophozoite. This promitosis distinguishes the Naegleria genus from Acanthamoeba spp. The disease caused by PAM usually occurs with acute onset, whereas chronic for GAE. The GAE cases mentioned are mostly in debilitated patients, chronic alcoholics or patients under treatment with immunosuppressive methods. About 6 cases of PAM were reported in Thailand during 1982-1997. Four cases of GAE were reported in 1994 and two isolated cases ofAcanthamoebafrom keratitis patients were reported in 2000. Finally one case of PAM and one case of GAE were reported in 2001. The surveys of FLA were set up to study the distribution of these pathogenic amoebae and determine the prevalence of amoebae in aquatic habitats of human environments. About 40% were identified as Acanthamoeba spp., 30% were Naegleria spp., 20% were Hartmanella and 10% were Vahlkampfia. Only 10% of Naegleria spp. belonged to Naegleria fowleri.

Abdome agudo por ruptura de abscesso amebiano do fígado: abordagem cirúrgica: a propósito de dois casos / Acute abdomen due rupture of the amebic liver abscess: surgical approach; apropos of two cases

O abscesso amebiano do fígado (AAF) é a manifestação extra-intestinal mais frequente da amebíase. A ruptura dos AAF para o peritôneo livre constitui-se em complicação grave e potencialmente letal - Objetivo - neste relato apresenta-se dois casos de homens apresentando dor abdominal, febre, hepatomegalia e distensão abdominal / The amebic liver abscess (ALA) is the most common extra intestinal affection in amebiasis. The rupture of the ALA to free peritoneum is a severe and potentially fatal complication. Aim - this is a report of two cases of young men with abdominal pain, fever, hepatomegaly and abdominal distension symptoms..

Strongyloidiasis associated with amebiasis and giardiaisis in an immunocompetent boy presented with acute abdomen

Strongyloides stercoralis (SS) is an intestinal nematode that is mainly endemic in tropical and subtropical regions and sporadic in temperate zones. SS infection frequently occurs in people who have hematologic malignancies, HIV infection and in individuals undergoing immunosuppressive therapy. In this study, we report a 12- year-old immunocompetent boy who was admitted to our hospital with acute abdomen. Laboratory evaluation showed strongyloidiasis, amebiasis and giardiasis. Clinical and laboratory findings immediately improved with albendazole therapy. Therefore, when diarrhea with signs of acute abdomen is observed, stool examinations should be done for enteroparasitosis. This approach will prevent misdiagnosis as acute abdomen. Complete clinical improvement is possible by medical therapy without surgical intervention.

Acanthameba meningoencephalitis: a case report.

A 45 year old lady presented with history of recent surgery for uterovaginal prolapse and retained vaginal tampons following which she developed chronic meningitis due to acanthameba infection. Patient responded to a regimen containing albendazole. She was left with hydrocephalus as a sequelae.

Infecções por "Entamoeba histolytica" / Entamoeba histolytica infections

Os autores discutem sobre as infecções relacionadas à Entamoeba histolytica, com o objetivo de proporcionar um melhor panorama do estado atual do problema

Fulminant amoebic colitis: a cause of caecal perforation

This is a report of caecal perforation, an infrequent complication of fulminant amoebic colitis, in a 51 year old man who was being treated with steroids for bronchial asthma. A right hemicolectomy was performed followed by the administration of metronidazole for 14 days which Resulted in a completed recovery

Parasitic disease of the liver and biliary tree

Several parasites infest liver or biliary tree, either during their maturation stages or as adult worms. biliary tree parasites may cause pancreatitis, cholecystitis, biliary tree obstruction, recurrent cholangitis, biliaiy tree strictures and some may lead to cholangiocarcinoma. This review discusses the hepatobilialy parasites, and shows our experience in diagnosis and management of these parasites. Ultrasonography of the liver is diagnostic in schistosomiasis, hydatid cysts, amebic liver abscess, ascariasis and other biliary tree parasites showing bile duct dilatation. Percutaneous aspiration under ultrasonography guidance of hydatid liver cysts or amebic abscess are effective measures in management. Endoscopic retrograde cholangiopancreatography [ERCP] is safe and effective in diagnosis and management of biliary tree parasites

Encefalitis amebiana granulomatosa en una paciente no inmunodeprimida: un hecho excepcional / Granulomatous amebic encephalitis in a non-immunosuppressed patient

La infección humana por amebas de vida libre es muy rara y en general grave. Las amebas de los géneros Naegleria determinan una meningoencefalitis aguda fulminante, y las del género Acanthamoeba una enfermedad subaguda granulomatosa que con más frecuencia se observa en pacientes inmunodeprimidos. Se estudió una paciente de medio rural, sin antecedentes patológicos, sin elementos de inmunosupresión,que ingresa con un cuadro de un mes de evolución, con crisis convulsivas. En la TAC presentó un proceso expansivo fronto-parietal. Se intervino quirúrgicamente con ese diagnóstico. La biopsia extemporánea informó proceso inflamatorio en bloque. El estudio anátomo patológico en diferido, mostró un proceso inflamatorio crónico granulomatoso necrotizante con escasa supuración, con microorganismos con formas quísticas y trofozoíticas entre 15 y 30 micras, que con las técnicas especiales son compatibles con amebas de vida libre. Se realizó el diagnóstico de Encefalitis Amebiana Granulomatosa (EAG). Esta entidad es muy rara y generalmente afecta a pacientes inmunodebilitados y es excepcional en pacientes inmunocompetentes. El tratamiento puede ser médico-quirúrgico o, quirúrgico con exéresis en bloque. Cuando el diagnóstico es precoz y es unifocal se puede obtener una excelente evolución, como en este caso

Influence of bacteria upon cytopathic effect and erythrophagocytosis of different axenic strains of entamoeba histolytica

Atualmente, tem se discutido muito a dualidade da Entamoeba histolystica. Na tentativa de contribuir no esclarecimento desta questao, investigamos a possibilidade de conversao de amebas avirulentas em virulentas, como tambem a possiblidade de aumento de virulencia de cepas virulentas seguido da associacao com bacterias. Para tal utilizamos 5 cepas de E. histolystica, 2 avirulentas e 3 virulentas. As amebas foram associadas com a s bacterias Escherichia coli 055 e 0115, demonstradas previamente como habeis para modificar o comportamento patogenico da E. histolystica...

Amebas patógenas de vida libre / Pathogenic free living amebas

Las pequeñas amebas de vida libre están ampliamente distribuidas en todo el mundo en continuo contacto con el hombre y animales; sus formas quísticas son capaces de sobrevivir en el suelo, aire y agua. Las infecciones causadas por las mismas han tomado en los últimos treinta años notable importancia médica ya que muchos casos fatales no fueron diagnosticados clínicamente ni por el laboratorio, debido al desconocimiento de la potencial capacidad patogénica de estas amebas. Hoy se sabe que la meningoencefalitis amebiana primaria (MAP) causada por Naegleria fowleri y la encefalitits amebiana granulomatosa (EAG) originada por especies de Acanthamoeba spp se han incrementado en el mundo tanto en sujetos sanos como en inmunocomprometidos, incluyendo muchos individuos con SIDA. El grupo más reciente de infecciones causadas por especies del género Acanthamoeba es la queratitis amebiana relacionada principalmente con la falta de cuidado en el mantenimiento de las lentes de contacto. La terapia de la queratitis es problemática debido a la presencia de quistes en los tejidos, y aunque se han informado algunas curas de pacientes, la terapéutica médica aún constituye un capítulo no resuelto

Corioamnioitis como causa de ictericia durante el embarazo / Chroriomnioitis as a cause of jundice during pregnancy

Se presenta el caso clínico de una paciente con corioamnioitis y sepsis por E. coli en el tercer trimestre de su gestación, cuya manifestación clínica principal fue un síndrome ictérico. La ictericia durante el embrazo presenta un amplio espectro de posibilidades etiológicas, aunque las más frecuentes son enfermedades primariamente de hígado o de la vías biliares, algunos procesos sistémicos como las infecciones o la eclampsia pueden asociarse a este síndrome. Se propone que, aunque no es una causa frecuente, debe considerarse a la corioamnioitis entre las causas de ictericia en el embarazo