1
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Yao Z, Liang M, Zhu S. Infectious factors in myocarditis: a comprehensive review of common and rare pathogens. Egypt Heart J 2024; 76:64. [PMID: 38789885 PMCID: PMC11126555 DOI: 10.1186/s43044-024-00493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Myocarditis is a significant health threat today, with infectious agents being the most common cause. Accurate diagnosis of the etiology of infectious myocarditis is crucial for effective treatment. MAIN BODY Infectious myocarditis can be caused by viruses, prokaryotes, parasites, and fungi. Viral infections are typically the primary cause. However, some rare opportunistic pathogens can also damage heart muscle cells in patients with immunodeficiencies, neoplasms and those who have undergone heart surgery. CONCLUSIONS This article reviews research on common and rare pathogens of infectious myocarditis, emphasizing the complexity of its etiology, with the aim of helping clinicians make an accurate diagnosis of infectious myocarditis.
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Affiliation(s)
- Zongjie Yao
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qindao, China.
| | - Mingjun Liang
- Department of Intensive Care Medicine, Shanghai Six People's Hospital Affilicated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Simin Zhu
- Wuhan Third Hospital-Tongren Hospital of Wuhan University, Wuhan, China
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2
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Lawati AA, Kashoub M, Busaidi IA, lal J, ElBingawi HM, Osman MM. Caecal Ameboma, colorectal malignancy mimicker in young male with ANCA-associated vasculitis. IDCases 2022; 31:e01649. [PMID: 36505909 PMCID: PMC9727639 DOI: 10.1016/j.idcr.2022.e01649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
Ameboma refers to the rare development of an inflammatory, ulcerated, exophytic mass in the gastrointestinal tract that can resemble carcinoma. Typically it presents as a right lower quadrant abdominal mass, Patients may also present with diarrhea or constipation and associated systemic symptoms, including weight loss and fever. In this article we present a young man with a background of ANCA associated vasculitis, who presented with fresh lower gastrointestinal bleeding during hospital admission for severe covid-19 pneumonia which turned out to be caecal aemboma. This case is highlighted for its rarity, the diagnostic challenge, and for the major role of colonoscopy as a diagnostic tool for this pathology.
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Affiliation(s)
- Ali Al Lawati
- Nephrology, SQUH, Oman,Correspondence to: Department of Medicine, Sultan Qaboos University, P.O. Box 35, P.C 123, Oman.
| | - Masoud Kashoub
- Internal Medicine Porgram, Oman Medical Speciality Board, Oman
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3
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Armstrong SM, Thavendiranathan P, Butany J. The pericardium and its diseases. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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4
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Varghese V, Kansal A, Bhardwaj S, Sharma A. Cerebral Amebiasis: An Uncommon Cerebral Abscess. Ann Indian Acad Neurol 2021; 24:445-447. [PMID: 34447021 PMCID: PMC8370162 DOI: 10.4103/aian.aian_583_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vineet Varghese
- Department of Neurosurgery, BLK Superspeciality Hospital, New Delhi, India
| | - Anil Kansal
- Department of Neurosurgery, BLK Superspeciality Hospital, New Delhi, India
| | - Sandeep Bhardwaj
- Department of Neurosurgery, BLK Superspeciality Hospital, New Delhi, India
| | - Akangsha Sharma
- Department of Neurosurgery, BLK Superspeciality Hospital, New Delhi, India
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5
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Nezaratizade S, Hashemi N, Ommi D, Orhan IE, Khamesipour F. A systematic review of anti- Entamoeba histolytica activity of medicinal plants published in the last 20 years. Parasitology 2021; 148:672-684. [PMID: 33536098 PMCID: PMC11010214 DOI: 10.1017/s0031182021000172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 02/05/2023]
Abstract
Amoebiasis has emerged as a major health problem worldwide. It is endemic in the present scenario is different and sub-tropical regions especially in Asia, Latin America and also in Africa. Causative of amoebiasis is a protozoan known as Entamoeba histolytica. We screened all the databases such as PubMed, Science Direct, Medline and Google Scholar by using the keywords ‘anti-Entamoeba histolytica activity of medicinal plants, anti-Entamoeba histolytica activity of herbal drugs, the anti-amoebic activity of natural drugs’. In the present study, we found 7861 articles, where all articles were screened for bias analysis and included 32 full-matching articles in total reporting the use of medicinal plants as a remedy for amoebiasis. Through these articles, we found 42 herbs having anti-amoebic activity. In bias analysis, we also found four articles under high bias risk. In our study, seven medicinal plants were concluded to possess the most potent anti-amoebic activity based on their IC50 value, which was less than 1 μg mL−1. On bias analysis, we found four articles with high bias risk, hence these studies can be repeated for better results.
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Affiliation(s)
- Saeed Nezaratizade
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Nooshin Hashemi
- School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Davood Ommi
- Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ilkay Erdogan Orhan
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara, Turkey
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6
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Devi S, Tomar P, Faisal Tarique K, Gourinath S. Inhibiting Pyridoxal Kinase of Entamoeba histolytica Is Lethal for This Pathogen. Front Cell Infect Microbiol 2021; 11:660466. [PMID: 33937101 PMCID: PMC8085340 DOI: 10.3389/fcimb.2021.660466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/29/2021] [Indexed: 11/19/2022] Open
Abstract
Pyridoxal 5’-phosphate (PLP) functions as a cofactor for hundreds of different enzymes that are crucial to the survival of microorganisms. PLP-dependent enzymes have been extensively characterized and proposed as drug targets in Entamoeba histolytica. This pathogen is unable to synthesize vitamin B6via de-novo pathway and relies on the uptake of vitamin B6 vitamers from the host which are then phosphorylated by the enzyme pyridoxal kinase to produce PLP, the active form of vitamin B6. Previous studies from our lab shows that EhPLK is essential for the survival and growth of this protozoan parasite and its active site differs significantly with respect to its human homologue making it a potential drug target. In-silico screening of EhPLK against small molecule libraries were performed and top five ranked molecules were shortlisted on the basis of docking scores. These compounds dock into the PLP binding site of the enzyme such that binding of these compounds hinders the binding of substrate. Of these five compounds, two compounds showed inhibitory activity with IC50 values between 100-250 μM when tested in-vitro. The effect of these compounds proved to be extremely lethal for Entamoeba trophozoites in cultured cells as the growth was hampered by 91.5% and 89.5% when grown in the presence of these compounds over the period of 72 hours.
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Affiliation(s)
- Suneeta Devi
- Structural Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Priya Tomar
- Structural Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Khaja Faisal Tarique
- Structural Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India.,Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, India
| | - Samudrala Gourinath
- Structural Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
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7
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Agarwal S, Rath PP, Anand G, Gourinath S. Uncovering the Cyclic AMP Signaling Pathway of the Protozoan Parasite Entamoeba histolytica and Understanding Its Role in Phagocytosis. Front Cell Infect Microbiol 2020; 10:566726. [PMID: 33102254 PMCID: PMC7546249 DOI: 10.3389/fcimb.2020.566726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023] Open
Abstract
Second messenger signaling controls a surprisingly diverse range of processes in several eukaryotic pathogens. Molecular machinery and pathways involving these messengers thus hold tremendous opportunities for therapeutic interventions. Relative to Ca2+ signaling, the knowledge of a crucial second messenger cyclic AMP (cAMP) and its signaling pathway is very scant in the intestinal parasite Entamoeba histolytica. In the current study, mining the available genomic resources, we have for the first time identified the cAMP signal transduction pathway of E. histolytica. Three heptahelical proteins with variable G-protein-coupled receptor domains, heterotrimeric G-proteins (Gα, Gβ, and Gγ subunits), soluble adenylyl cyclase, cyclase-associated protein, and enzyme carbonic anhydrase were identified in its genome. We could also identify several putative candidate genes for cAMP downstream effectors such as protein kinase A, A-kinase anchoring proteins, and exchange protein directly activated by the cAMP pathway. Using specific inhibitors against key identified targets, we could observe changes in the intracellular cAMP levels as well as defect in the rate of phagocytosis of red blood cells by the parasite E. histolytica. We thus strongly believe that characterization of some of these unexplored crucial signaling determinants will provide a paradigm shift in understanding the pathogenicity of this organism.
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Affiliation(s)
- Shalini Agarwal
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | | | - Gaurav Anand
- International Center for Genetic Engineering and Biotechnology, New Delhi, India
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8
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Keleş Alp E, Alp H, Keçeli M. Myocarditis Associated With Enteric Amebiasis in an Adolescent. World J Pediatr Congenit Heart Surg 2020; 11:658-660. [PMID: 32853078 DOI: 10.1177/2150135120930001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parasitic diseases may occasionally affect the cardiovascular system while it is rarely seen in childhood. Parasites may directly or indirectly affect the heart in the form of myocarditis, pericarditis, pancarditis, or pulmonary hypertension. Therefore, it should be kept in mind that parasites may be responsible for myocardial and pericardial disease anywhere around the globe. Herein, we report an adolescent boy with myocarditis associated with enteric amebiasis.
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Affiliation(s)
- Esma Keleş Alp
- Department of Pediatrics, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
| | - Hayrullah Alp
- Department of Pediatric Cardiology, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
| | - Merter Keçeli
- Department of Pediatric Radiology, 147027Konya Training and Research Hospital, Konya, Turkey
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9
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Abstract
BACKGROUND Infection with the protozoan Entamoeba histolytica is common in low- and middle-income countries, and up to 100,000 people with severe disease die every year. Adequate therapy for amoebic colitis is necessary to reduce illness, prevent development of complicated disease and extraintestinal spread, and decrease transmission. OBJECTIVES To evaluate antiamoebic drugs for treating amoebic colitis. SEARCH METHODS We searched the available literature up to 22 March 2018. We searched the Cochrane Infectious Diseases Group Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, mRCT, and conference proceedings. We contacted individual researchers, organizations, and pharmaceutical companies, and we checked reference lists. SELECTION CRITERIA Randomized controlled trials of antiamoebic drugs given alone or in combination, compared with placebo or another antiamoebic drug, for treating adults and children with a diagnosis of amoebic colitis. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility and methodological quality of trials and extracted and analysed the data. We calculated clinical and parasitological failure rates and rates of relapse and adverse events as risk ratios (RRs) with 95% confidence intervals (CIs), using a random-effects model. We determined statistical heterogeneity and explored possible sources of heterogeneity using subgroup analyses. We carried out sensitivity analysis by using trial quality to assess the robustness of reported results. MAIN RESULTS In total, 41 trials (4999 participants) met the inclusion criteria of this review. In this update, we added four trials to the 37 trials included in the first published review version. Thirty trials were published over 20 years ago. Only one trial used adequate methods of randomization and allocation concealment, was blinded, and analysed all randomized participants. Only one trial used an E histolytica stool antigen test, and two trials used amoebic culture.Tinidazole may be more effective than metronidazole for reducing clinical failure (RR 0.28, 95% CI 0.15 to 0.51; 477 participants, eight trials; low-certainty evidence) and is probably associated with fewer adverse events (RR 0.65, 95% CI 0.46 to 0.92; 477 participants, 8 trials; moderate-certainty evidence). Compared with metronidazole, combination therapy may result in fewer parasitological failures (RR 0.36, 95% CI 0.15 to 0.86; 720 participants, 3 trials; low-certainty evidence), but we are uncertain which combination is more effective than another. Evidence is insufficient to allow conclusions regarding the efficacy of other antiamoebic drugs. AUTHORS' CONCLUSIONS Compared with metronidazole, tinidazole may be more effective in reducing clinical failure and may be associated with fewer adverse events. Combination drug therapy may be more effective for reducing parasitological failure compared with metronidazole alone. However, these results are based mostly on small trials conducted over 20 years ago with a variety of poorly defined outcomes. Tests that detect E histolytica more accurately are needed, particularly in countries where concomitant infection with other bacteria and parasites is common.
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Affiliation(s)
- Maria Liza M Gonzales
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
| | - Leonila F Dans
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
| | - Juliet Sio‐Aguilar
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
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10
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Martínez-Castillo M, Pacheco-Yepez J, Flores-Huerta N, Guzmán-Téllez P, Jarillo-Luna RA, Cárdenas-Jaramillo LM, Campos-Rodríguez R, Shibayama M. Flavonoids as a Natural Treatment Against Entamoeba histolytica. Front Cell Infect Microbiol 2018; 8:209. [PMID: 29988403 PMCID: PMC6024094 DOI: 10.3389/fcimb.2018.00209] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/05/2018] [Indexed: 02/05/2023] Open
Abstract
Over the past 20 years, gastrointestinal infections in developing countries have been a serious health problem and are the second leading cause of morbidity among all age groups. Among pathogenic protozoans that cause diarrheal disease, the parasite Entamoeba histolytica produces amebic colitis as well as the most frequent extra-intestinal lesion, an amebic liver abscess (ALA). Usually, intestinal amebiasis and ALA are treated with synthetic chemical compounds (iodoquinol, paromomycin, diloxanide furoate, and nitroimidazoles). Metronidazole is the most common treatment for amebiasis. Although the efficacy of nitroimidazoles in killing amebas is known, the potential resistance of E. histolytica to this treatment is a concern. In addition, controversial studies have reported that metronidazole could induce mutagenic effects and cerebral toxicity. Therefore, natural and safe alternative drugs against this parasite are needed. Flavonoids are natural polyphenolic compounds. Flavonoids depend on malonyl-CoA and phenylalanine to be synthesized. Several flavonoids have anti-oxidant and anti-microbial properties. Since the 1990s, several works have focused on the identification and purification of different flavonoids with amebicidal effects, such as, -(-)epicatechin, kaempferol, and quercetin. In this review, we investigated the effects of flavonoids that have potential amebicidal activity and that can be used as complementary and/or specific therapeutic strategies against E. histolytica trophozoites. Interestingly, it was found that these natural compounds can induce morphological changes in the amebas, such as chromatin condensation and cytoskeletal protein re-organization, as well as the upregulation and downregulation of fructose-1,6-bisphosphate aldolase, glyceraldehyde-phosphate dehydrogenase, and pyruvate:ferredoxin oxidoreductase (enzymes of the glycolytic pathway). Although the specific molecular targets, bioavailability, route of administration, and doses of some of these natural compounds need to be determined, flavonoids represent a very promising and innocuous strategy that should be considered for use against E. histolytica in the era of microbial drug resistance.
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Affiliation(s)
- Moisés Martínez-Castillo
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Judith Pacheco-Yepez
- Sección de Estudios de Posgrado e Investigación, Instituto Politécnico Nacional, Escuela Superior de Medicina, Ciudad de México, Mexico
| | - Nadia Flores-Huerta
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Paula Guzmán-Téllez
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Rosa A Jarillo-Luna
- Sección de Estudios de Posgrado e Investigación, Instituto Politécnico Nacional, Escuela Superior de Medicina, Ciudad de México, Mexico
| | - Luz M Cárdenas-Jaramillo
- Coordinación de Morfología, Departamento de Formación Básica Disciplinaria, Instituto Politécnico Nacional, Escuela Superior de Medicina, Ciudad de México, Mexico
| | - Rafael Campos-Rodríguez
- Sección de Estudios de Posgrado e Investigación, Instituto Politécnico Nacional, Escuela Superior de Medicina, Ciudad de México, Mexico
| | - Mineko Shibayama
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
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11
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Comparative study of tinidazole versus metronidazole in treatment of amebic liver abscess: A randomized control trial. Indian J Gastroenterol 2018; 37:196-201. [PMID: 29948994 DOI: 10.1007/s12664-018-0848-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/27/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Metronidazole is a drug of choice for amebic liver abscess (ALA), but has long course and significant side effects. Thus, drugs like tinidazole with a better tolerability record need evaluation. METHODS We conducted a randomized controlled trial at the Department of Gastroenterology, SMS Hospital, Jaipur, India. One hundred and fifty admitted patients were randomized into two treatment groups, metronidazole (group M, n = 75) and tinidazole (group T, n = 75). Patients were observed for clinical response, laboratory parameters, imaging, and side effects. Early clinical response (ECR) was defined as the absence of fever and abdominal pain within 72 h of treatment. Symptomatic clinical response (SCR) was defined as the absence of fever and abdominal pain irrespective of duration of treatment required. Follow up was done at 1, 3, and 6 months. RESULTS ECR was 62.3% in group T vs. 37.7% in group M (p = 0.02). SCR was shorter in group T than group M (3.29 ± 1.61 days vs. 5.67 ± 2.93, p ≤ 0.001). Mean residual volume at the end of 1 month was lower in group T (130.7 ± 108.1 vs. 184.7 ± 143.3 mL, p = 0.01) and no significant difference was seen at 3 and 6 months. Tinidazole was better tolerated with fewer side effects. Low socioeconomic status, baseline abscess volume > 500 mL, hypoalbuminemia, pleural effusion, and history of ethanol use were associated with a late clinical response on univariate analysis of which low socioeconomic status was the only associated factor. CONCLUSION Tinidazole, as compared to metronidazole, has early clinical response, shorter treatment course, favorable rate of recovery, and high tolerability; thus, tinidazole can be preferred over metronidazole in ALA.
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12
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Goel P, Tyagi R, Kaur G, Garg B, Selhi PK, Kaur H, Mehta V, Sood N. Entamoeba histolytica: A surprising coexistence with adenocarcinoma - Never brush aside brushings for biopsy. J Lab Physicians 2018; 10:251-254. [PMID: 29692598 PMCID: PMC5896199 DOI: 10.4103/jlp.jlp_129_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Entamoeba histolytica has been rarely reported as superadded infection over carcinomatous growth on rectal brushings. We present a case of 68-year-old male who presented with abdominal pain and bleeding per rectum who was found to have an ulceroproliferative growth on sigmoidoscopy. Rectal brushings revealed coexistence of E. histolytica with malignant cells of adenocarcinoma. No organism was detected on biopsy of the tumor, which also showed adenocarcinoma, because of possible surface colonization of the tumor by Entamoeba. This case highlights the role of rectal brushings in detecting superadded infection in a case where both brushings and biopsy were performed. It is always important to report infection superadded on malignancies for optimum management of the patients.
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Affiliation(s)
- Palvi Goel
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Gursheen Kaur
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Bhavna Garg
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Pavneet Kaur Selhi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Varun Mehta
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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13
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Hayat F, Azam A, Shin D. Recent progress on the discovery of antiamoebic agents. Bioorg Med Chem Lett 2016; 26:5149-5159. [PMID: 27707603 DOI: 10.1016/j.bmcl.2016.09.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 12/12/2022]
Abstract
A large number of protozoans infect humans but Entamoeba histolytica is the only organism responsible for causing amoebiasis, a deadly disease after malaria. Numerous heterocycle-based antiamoebic agents have been previously synthesized as E. histolytica inhibitors and while some of these agents have shown moderate activity, the search for a novel and ideal antiamoebic compound is still ongoing. In this digest Letter, we present the latest data on antiamoebic agents from 2011 to 2016 based on the different classes of heterocyclic agents.
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Affiliation(s)
- Faisal Hayat
- College of Pharmacy, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, South Korea
| | - Amir Azam
- Department of Chemistry, Jamia Millia Islamia (Central University), Jamia Nagar, New Delhi 110025, India
| | - Dongyun Shin
- College of Pharmacy, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, South Korea.
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14
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The Pericardium and Its Diseases. Cardiovasc Pathol 2016. [DOI: 10.1016/b978-0-12-420219-1.00015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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15
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Kasamatsu Y, Shirano M, Iida K, Shimizu S, Goto T. Multiple Medium Amoebic Liver Abscesses Successfully Treated with Medication and Comprehensive Percutaneous Catheter Drainage. Intern Med 2016; 55:2307-10. [PMID: 27523014 DOI: 10.2169/internalmedicine.55.5668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Solitary small (<5 cm) amoebic liver abscesses in the right lobe are generally treated using medication alone, while large abscesses are typically treated via a combination of medication and drainage. However, the therapeutic indications for multiple medium (5-10 cm) amoebic liver abscesses remain unclear. We herein report the findings of a 53-year-old woman who was receiving lenalidomide for multiple myeloma and subsequently developed multiple amoebic abscesses. Metronidazole alone was unsuccessful, although metronidazole and repeated percutaneous catheter drainage of the right lobe, left lobe, and thorax proved to ultimately be successful. Therefore, the successful use of medication alone may be associated with the total combined abscess volume.
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Affiliation(s)
- Yu Kasamatsu
- Department of Infectious Disease, Osaka City General Hospital, Japan
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16
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Fleming R, Cooper CJ, Ramirez-Vega R, Huerta-Alardin A, Boman D, Zuckerman MJ. Clinical manifestations and endoscopic findings of amebic colitis in a United States-Mexico border city: a case series. BMC Res Notes 2015; 8:781. [PMID: 26666636 PMCID: PMC4678475 DOI: 10.1186/s13104-015-1787-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 12/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background Invasive amebiasis is not frequently seen in the United States. It is associated with considerable morbidity in patients residing in or traveling to endemic areas. We report a case series of patients with amebic colitis in a United States-Mexico border city to alert physicians to the varied clinical manifestations. Case presentation Nine patients were diagnosed with amebic colitis. Mean age was 56 (38–83), 6 were males, and all were Hispanic. Common symptoms were diarrhea (56 %), hematochezia (33 %) and abdominal bloating (11 %). The diagnosis of amebic colitis was established in the following ways: 8 patients by colonoscopy with biopsy, 1 by surgery for colonic obstruction. The diagnosis of amebic colitis was confirmed in 8 patients (89 %) by amebic trophozoites present in histopathologic sections. One patient was diagnosed with amebic colitis based upon clinical symptoms, colitis on colonoscopy and visualization of amebic trophozoites on stool examination. In the 8 patients in whom colonoscopy was done, 6 (75 %) had inflammation with rectosigmoid involvement and 5 (62.5 %) had ulcerations. Infection resolved after treatment with metronidazole in most patients; however, one patient developed a liver abscess and another had a colonic perforation and later developed a liver abscess. Conclusion The occurrence of amebic colitis in this United States-Mexico border city hospital population was low, but in some cases potentially life-threatening. Physicians should be alert to the less common presentations of amebic colitis, such as overt gastrointestinal bleeding, exacerbation of inflammatory bowel disease, and the incidental finding of association with colon cancer, or a surgical abdomen. Rectosigmoid involvement was typically found on colonoscopy.
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Affiliation(s)
- Rhonda Fleming
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
| | - Chad J Cooper
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
| | - Ruben Ramirez-Vega
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
| | - Ana Huerta-Alardin
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
| | - Darius Boman
- Department of Pathology, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
| | - Marc J Zuckerman
- Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA.
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Numata A, Itabashi M, Kishimoto K, Motohashi K, Hagihara M, Kuwabara H, Tanaka M, Kato H, Chiba S, Kunisaki R, Fujisawa S. Intestinal amoebiasis in a patient with acute graft-versus-host disease after allogeneic bone marrow transplantation successfully treated by metronidazole. Transpl Infect Dis 2015; 17:886-9. [PMID: 26426525 DOI: 10.1111/tid.12460] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/27/2015] [Accepted: 09/12/2015] [Indexed: 11/28/2022]
Abstract
Amoebiasis has rarely been reported in patients undergoing hematopoietic stem cell transplantation, although it is a world-wide infection and extremely common. We present a case of intestinal amoebiasis unexpectedly revealed by colonoscopy after allogeneic bone marrow transplantation from a human leukocyte antigen-mismatched unrelated donor for acute myeloid leukemia arising from chronic myelomonocytic leukemia and successfully treated by metronidazole.
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Affiliation(s)
- A Numata
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - M Itabashi
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - K Kishimoto
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - K Motohashi
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - M Hagihara
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - H Kuwabara
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - M Tanaka
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - H Kato
- Infection Control Department, Yokohama City University Medical Center, Yokohama, Japan
| | - S Chiba
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - R Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - S Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
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18
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Jaiswal SS, Mehra R, Pattnaik MR. Amoeboma-lest we forget!!! Indian J Surg 2015; 77:190-2. [PMID: 25972693 DOI: 10.1007/s12262-015-1267-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 04/02/2015] [Indexed: 11/26/2022] Open
Abstract
Amoebiasis is an infection with the parasitic intestinal protozoan Entamoeba histolytica (E. histolytica). Most infections are usually asymptomatic, but the disease spectrum can range from dysentery to extraintestinal infections, including liver abscesses. The management of a 68-year-old male with amoeboma, a rare manifestation of intestinal amoebiasis, is described along with a review of literature.
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Affiliation(s)
- S S Jaiswal
- Department of Surgery, Armed Forces Medical College (AFMC), Pune, 411040 India
| | - R Mehra
- Department of Surgery, Armed Forces Medical College (AFMC), Pune, 411040 India
| | - M R Pattnaik
- Department of Surgery, Armed Forces Medical College (AFMC), Pune, 411040 India
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19
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Abstract
PURPOSE OF REVIEW To highlight new findings on the relevance of gastrointestinal protozoan infections to global public health in low-income and middle-income countries and suggest new large-scale interventions. RECENT FINDINGS New disease burden assessments and epidemiological studies highlight the role of the major intestinal protozoa as important etiologic disease agents in low-income and middle-income countries. Despite their prevalence and adverse health impact, such information has not yet translated to the implementation of large-scale interventions as exist for helminth infections and other neglected tropical diseases. There are also several key research and development questions that must be addressed for intestinal protozoan infections and the potential need for new tools, for example, drugs, diagnostics, and vaccines. Additional studies have identified new and emerging species of intestinal protozoa relevant to global public health such as Dientamoeba fragilis and Blastocystis hominis and how they too might emerge as important gastrointestinal pathogens in the coming years. SUMMARY New and emerging information on intestinal protozoa are reviewed with emphasis on aspects considered relevant to global health policymakers including prospects for scaling up interventions against intestinal protozoan infections in resource-poor countries.
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20
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Parija SC, Mandal J, Ponnambath DK. Laboratory methods of identification of Entamoeba histolytica and its differentiation from look-alike Entamoeba spp. Trop Parasitol 2014; 4:90-5. [PMID: 25250228 PMCID: PMC4166809 DOI: 10.4103/2229-5070.138535] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 08/12/2014] [Indexed: 11/30/2022] Open
Abstract
Entamoeba histolytica, the causative agent of intestinal and extraintestinal amebiasis, is a common parasitic cause of significant morbidity and mortality in the developing countries. Hence, early detection and differentiation of pathogenic E. histolytica from nonpathogenic/commensal Entamoeba spp (Entamoeba dispar/Entamoeba moshkovskii/Entamoeba bangladeshi) plays a crucial role in clinical management of patients with amebiasis. Most diagnostic tests currently available do not reliably differentiate between the species of Entamoeba and are less sensitive, cumbersome to perform. Molecular-based methods are highly sensitive, easy to perform and differentiates the pathogenic Entamoeba from nonpathogenic species, serving the criteria for an ideal diagnostic test for amebiasis. Recently, microarray technology has been found to be a promising tool for the diagnostic and epidemiological evaluation of amebiasis.
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Affiliation(s)
- Subhash Chandra Parija
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research Gorimedu, Puducherry, India
| | - Jharna Mandal
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research Gorimedu, Puducherry, India
| | - Dinoop Korol Ponnambath
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research Gorimedu, Puducherry, India
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21
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Mogensen TH, Christiansen JJ, Eivindson MV, Larsen CS, Tøttrup A. Misdiagnosed amoebic colitis leading to severe dysentery and necrotizing colitis--report of a case and review of the literature. ACTA ACUST UNITED AC 2014; 46:235-9. [PMID: 24450838 DOI: 10.3109/00365548.2013.871646] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We present a case of amoebic colitis, misdiagnosed as inflammatory bowel disease and treated with corticosteroids, leading to severe necrotizing enterocolitis. We review the literature on the epidemiology, pathogenesis, diagnosis, and treatment of amoebic dysentery, with special emphasis on the association between immunosuppressive treatment and the development of severe invasive amoebiasis.
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Affiliation(s)
- Trine H Mogensen
- From the Department of Infectious Diseases, Aarhus University Hospital Skejby , Denmark
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22
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Soentjens P, Ostyn B, Clerinx J, Van Gompel A, Colebunders R. A CASE OF MULTIPLE AMOEBIC LIVER ABSCESSES: CLINICAL IMPROVEMENT AFTER PERCUTANEOUS ASPIRATION. Acta Clin Belg 2014. [DOI: 10.1179/acb.2005.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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23
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Abstract
Entamoeba histolytica infections of the gastrointestinal tract are common in the developing world but rare in North America. The authors present two cases: one involving an individual who had not travelled to an endemic area and another involving an individual who was born in Bulgaria. Both presented with severe abdominal pain and diarrhea. Endoscopic assessment revealed scattered colonic ulcerations and one patient was found to have a liver abscess on imaging. Stool ova and parasite studies were negative in both cases and both were diagnosed on review of colonic biopsies. On review of all Entamoeba cases in the Calgary Health Zone (Alberta), ova and parasite analysis found an average of 63.7 Entamoeba cases per year and a pathology database review revealed a total of seven cases of invasive E histolytica (2001 to 2011). Both patients responded well to antibiotic therapy. E histolytica should be considered in new-onset colitis, especially in individuals from endemic areas.
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24
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Abstract
Ameboma is a rare complication of amebic colitis presenting as a mass of granulation tissue with peripheral fibrosis and a core of inflammation related to amebic chronic infection. The initial presentations are usually obstruction and low gastrointestinal bleeding. The most common sites are the ascending colon and the cecum. It may mimic colon carcinoma, Crohn's disease, carcinoma of the colon, non-Hodgkin's lymphoma, tuberculosis, fungal infection, AIDS-associated lymphoma and Kaposi's sarcoma in colonoscopy findings. The therapeutic strategy should be combined with antibiotics for invasive dysentery and eradication of luminal cysts.
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Affiliation(s)
- Chung-Cheng Lin
- Division of Gastroenterology, Department of Internal Medicine, Pingtung Hospital, Pingtung, Taipei, Taiwan
| | - Kuo-Yao Kao
- Division of General Surgery, Department of Surgery, Shin Kong Wo Ho-Su Memorial Hospital, Taipei, Taiwan
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25
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Saucedo-Mendiola ML, Salas-Pacheco JM, Nájera H, Rojo-Domínguez A, Yépez-Mulia L, Avitia-Domínguez C, Téllez-Valencia A. Discovery of Entamoeba histolytica hexokinase 1 inhibitors through homology modeling and virtual screening. J Enzyme Inhib Med Chem 2013; 29:325-32. [PMID: 23534932 DOI: 10.3109/14756366.2013.779265] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Entamoeba histolytica, the parasite which causes amebiasis is responsible for 110,000 deaths a year. Entamoeba histolytica depends on glycolysis to obtain ATP for cellular work. According to metabolic flux studies, hexokinase exerts the highest flux control of this metabolic pathway; therefore, it is an excellent target in the search of new antiamebic drugs. To this end, a tridimensional model of E. histolytica hexokinase 1 (EhHK1) was constructed and validated by homology modeling. After virtual screening of 14,400 small molecules, the 100 with the best docking scores were selected, purchased and assessed in their inhibitory capacity. The results showed that three molecules (compounds 2921, 11275 and 2755) inhibited EhHK1 with an I50 of 48, 91 and 96 µM, respectively. Thus, we found the first inhibitors of EhHK1 that can be used in the search of new chemotherapeutic agents against amebiasis.
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Affiliation(s)
- María Leticia Saucedo-Mendiola
- Facultad de Ciencias Químicas, Universidad Juárez del Estado de Durango, Av. Veterinaria S/N Circuito Universitario , Durango , México
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26
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Swaminathan V, O'Rourke J, Gupta R, Kiire CF. An unusual presentation of an amoebic liver abscess: the story of an unwanted souvenir. BMJ Case Rep 2013; 2013:bcr-2012-006964. [PMID: 23389718 DOI: 10.1136/bcr-2012-006964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This case was rather unusual with regard to the disease presentation. The patient had non-specific symptoms of weight loss and general malaise, without any history of preceding diarrhoea or dysentery. It is important to be aware of the epidemiology of the disease, and to relate it to patients presenting with symptoms suggestive of amoebiasis. We discuss the recommended investigations and management options for these patients based on the current guidelines/evidence.
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Affiliation(s)
- Vikram Swaminathan
- Department of Surgery, Southport District General Hospital, Southport, UK.
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27
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Nagata N, Shimbo T, Akiyama J, Nakashima R, Nishimura S, Yada T, Watanabe K, Oka S, Uemura N. Risk factors for intestinal invasive amebiasis in Japan, 2003-2009. Emerg Infect Dis 2013. [PMID: 22515839 DOI: 10.3201/eid] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
We determined yearly change in prevalence and risk factors for amebic colitis caused by intestinal invasive amebiasis among persons who underwent endoscopy and assessed differences between HIV-positive and HIV-negative persons in Japan. A total of 10,930 patients were selected for analysis, of whom 54 had amebic colitis. Prevalence was in 2009 (0.88%, 12/1360) compared with 2003 (0.16%, 3/1904). Male sex (odds ratio [OR] 8.39, 95% CI 1.99-35.40), age <50 years (OR 4.73, 95% CI 2.43-9.20), history of syphilis (OR 2.90, 95% CI 1.40-5.99), and HIV infection (OR 15.85, 95% CI 7.93-31.70) were independent risk factors. No differences in risk factors were identified between HIV-positive and HIV-negative patients. Contact with commercial sex workers was a new risk factor among HIV-negative patients. Homosexual intercourse, rather than immunosuppressed status, appears to be a risk factor among HIV-positive patients.
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Affiliation(s)
- Naoyoshi Nagata
- National Center for Global Health and Medicine, Tokyo, Japan.
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28
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Nagata N, Shimbo T, Akiyama J, Nakashima R, Nishimura S, Yada T, Watanabe K, Oka S, Uemura N. Risk factors for intestinal invasive amebiasis in Japan, 2003-2009. Emerg Infect Dis 2013; 18:717-24. [PMID: 22515839 PMCID: PMC3358059 DOI: 10.3201/eid1805.111275] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Amebic colitis is increasing among younger men who have syphilis or HIV.
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Affiliation(s)
- Naoyoshi Nagata
- National Center for Global Health and Medicine, Tokyo, Japan.
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29
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Wuerz T, Kane JB, Boggild AK, Krajden S, Keystone JS, Fuksa M, Kain KC, Warren R, Kempston J, Anderson J. A review of amoebic liver abscess for clinicians in a nonendemic setting. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2012; 26:729-33. [PMID: 23061067 PMCID: PMC3472914 DOI: 10.1155/2012/852835] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 04/18/2012] [Indexed: 01/11/2023]
Abstract
Amoebic liver abscess (ALA) is an uncommon but potentially life-threatening complication of infection with the protozoan parasite Entamoeba histolytica. E histolytica is widely distributed throughout the tropics and subtropics, causing up to 40 million infections annually. The parasite is transmitted via the fecal-oral route, and once it establishes itself in the colon, it has the propensity to invade the mucosa, leading to ulceration and colitis, and to disseminate to distant extraintestinal sites, the most common of which is the liver. The authors provide a topical review of ALA and summarize clinical data from a series of 29 patients with ALA presenting to seven hospitals in Toronto, Ontario, a nonendemic setting, over 30 years.
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Affiliation(s)
- Terry Wuerz
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba
| | | | - Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
| | | | - Jay S Keystone
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
| | | | - Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
- Sandra A Rotman Laboratories, McLaughlin-Rotman Centre for Global Health, Toronto General Hospital-University Health Network
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30
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Nagata N, Shimbo T, Akiyama J, Niikura R, Watanabe K, Oka S, Uemura N. Diagnostic accuracy of indirect immunofluorescence assay for intestinal invasive amebiasis and impact of HIV infection in a non-endemic country. Diagn Microbiol Infect Dis 2012; 74:374-8. [PMID: 23017259 DOI: 10.1016/j.diagmicrobio.2012.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/14/2012] [Accepted: 08/20/2012] [Indexed: 11/30/2022]
Abstract
To diagnose amebic colitis (AC), serologic tests have the advantage of being inexpensive, noninvasive, and easy to perform, but few studies have investigated their utility, especially in a non-endemic country. A total of 299 symptomatic patients (165 HIV-infected patients) who underwent endoscopy and indirect immunofluorescence (IF) assay were analyzed between 2003 and 2009. The diagnosis of AC was defined as detection of amebic trophozoites from biopsy specimens or intestinal fluid sample via endoscopy. Forty-five patients (29 HIV-infected patients) were diagnosed with AC. The area under the receiver-operating characteristic curve (ROC-AUC) for the IF assay was excellent (0.90), and a cut-off value of 100 provided 89% sensitivity and 87% specificity. ROC-AUC was slightly lower in patients with HIV infection (0.88) than in those without HIV infection (0.94). Among HIV-infected patients, ROC-AUC showed no significant differences between different CD4+ cell counts. The IF assay is useful for diagnosing AC in symptomatic patients with and those without HIV infection.
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Affiliation(s)
- Naoyoshi Nagata
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan.
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31
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Salahuddin A, Agarwal SM, Avecilla F, Azam A. Metronidazole thiosalicylate conjugates: Synthesis, crystal structure, docking studies and antiamoebic activity. Bioorg Med Chem Lett 2012; 22:5694-9. [DOI: 10.1016/j.bmcl.2012.06.083] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 06/23/2012] [Accepted: 06/26/2012] [Indexed: 11/29/2022]
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33
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Choudhuri G, Rangan M. Amebic infection in humans. Indian J Gastroenterol 2012; 31:153-62. [PMID: 22903366 DOI: 10.1007/s12664-012-0192-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 05/21/2012] [Indexed: 02/04/2023]
Abstract
Clinical human infections with the protozoa Entamoeba histolytica is still estimated to occur in 50 million people worldwide, of which approximately 100,000 die annually. Although most clinical symptoms are due to involvement of the large intestine, 1 % present with involvement of the liver in the form of a liver abscess, a potentially fatal condition. Distinguishing an invasive form (E. histolytica) from a morphologically identical non-invasive one (E. dispar) requires molecular or enzymatic characterization. Further, the pattern of infection, interpretation of presence of antibodies in the host, manifestations of disease, approach to investigations and strategies for management remain complex. This article also provides a comprehensive review of the parasite and host factors that govern the complex relationship of the prozoa and humans, and tries to explain why some develop a particular form of the disease in endemic zones. Application of modern imaging and image guided therapy seems to be playing a major role in diagnosis and management of the potentially most serious form of the disease, amebic liver abscess. Despite lack of controlled studies there is a tendency to lower the threshold of their use in clinical practice, and indeed in-hospital mortality rate seems to be falling for amebic liver abscess. In a world getting increasingly swamped by non-infectious metabolic diseases, awareness of amebic infections, its bed-side diagnosis, the use of appropriate laboratory tests, and decision making in management are shrinking. This review tries to update the scientific developments in amebiasis.
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Affiliation(s)
- Gourdas Choudhuri
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
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34
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Yang B, Chen Y, Wu L, Xu L, Tachibana H, Cheng X. Seroprevalence of Entamoeba histolytica infection in China. Am J Trop Med Hyg 2012; 87:97-103. [PMID: 22764298 PMCID: PMC3391064 DOI: 10.4269/ajtmh.2012.11-0626] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 04/14/2012] [Indexed: 12/23/2022] Open
Abstract
The seroprevalence of Entamoeba histolytica infection in the residents of seven provinces in China was examined by using an enzyme-linked immunosorbent assay with a crude antigen and a recombinant surface antigen, C-Igl, of the parasites. A total of 1,312 serum samples were investigated. The positivity rates for these two antigens were 11.05% and 6.25%, respectively. There was no significant difference in the seropositivity to E. histolytica between men and women. We used a logistic regression model and maximal-likelihood methods to estimate the prevalence of E. histolytica infection from sequential serologic data. Seropositivity in Sichuan, Guizhou, and Sinkiang Provinces was higher than that in Beijing, Shanghai, and Qinghai Provinces. The present study provides an overview of seropositivity to E. histolytica infection in seven provinces in China and use the logistic regression model estimation method to achieve a more accurate measure of amebiasis prevalence.
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Affiliation(s)
- Bin Yang
- Department of Microbiology and Parasitology, Shanghai Medical College, Fudan University, Shanghai, China.
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35
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Abstract
Metronidazole is a treatment of choice for several types of infections, but coexisting conditions or concomitant medications may preclude its use. Although tinidazole, a newer nitroimidazole, may be an option in cases where drug interactions make the use of metronidazole inadvisable, similar absolute contraindications exist. In situations where nitroimidazole use is contraindicated or inadvisable, clinicians may have difficulty deciding on efficacious treatment options. For the treatment of trichomoniasis, alternatives include furazolidone, clotrimazole, nonoxynol-9 or paromomycin. Alternatives for bacterial vaginosis include clindamycin topically or systemically. For giardiasis, alternative options include paromomycin, nitazoxanide or the antihelminthic benzimidazoles. Alternatives for Clostridium difficile are varied, including oral vancomycin, nitazoxanide and rifaximin. Although options are limited, alternative therapies for treatment of patients with absolute contraindications to the nitroimidazole antibiotics are available.
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Abstract
Traveler's diarrhea (TD) strikes 20-60% of travelers visiting developing countries. It occurs shortly after the return and can be distinguished into two categories: acute and persistent TD. Acute TD, mostly caused by bacterial and viral pathogens, is usually mild and self-limited, and deserves empirical symptomatic and/or antibiotic therapy in selected cases. Fluoroquinolones are progressively superseded in this indication by azithromycin, a well tolerated macrolide active against most bacteria responsible for TD, including the quinolone-resistant species of Campylobacter jejuni that are now pervasive, especially in Southeast Asia and India. Persistent TD in the returning traveler is much rarer than its acute counterpart and may be associated with three types of causes. Persistent infections, among which Giardia and possibly Entamoeba predominate, account for a significant proportion of cases. Postinfectious processes represent a second cause and comprise temporary lactose malabsorption and postinfectious irritable bowel syndrome, now considered a major cause of persistent TD. Finally, apparently unrelated chronic diseases causing diarrhea are occasionally unmasked by TD and represent a third type of persistent TD, among which the well established case of incident inflammatory bowel disease poses intriguing pathogenesis questions. This review discusses recent advances in the field and provides practical recommendations for the management of TD in adult, immunocompetent returning travelers.
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38
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Abstract
Parasitic infections previously seen only in developing tropical settings can be currently diagnosed worldwide due to travel and population migration. Some parasites may directly or indirectly affect various anatomical structures of the heart, with infections manifested as myocarditis, pericarditis, pancarditis, or pulmonary hypertension. Thus, it has become quite relevant for clinicians in developed settings to consider parasitic infections in the differential diagnosis of myocardial and pericardial disease anywhere around the globe. Chagas' disease is by far the most important parasitic infection of the heart and one that it is currently considered a global parasitic infection due to the growing migration of populations from areas where these infections are highly endemic to settings where they are not endemic. Current advances in the treatment of African trypanosomiasis offer hope to prevent not only the neurological complications but also the frequently identified cardiac manifestations of this life-threatening parasitic infection. The lack of effective vaccines, optimal chemoprophylaxis, or evidence-based pharmacological therapies to control many of the parasitic diseases of the heart, in particular Chagas' disease, makes this disease one of the most important public health challenges of our time.
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Abstract
Gastrointestinal (GI) infections are a major cause of morbidity and mortality worldwide. Although infectious organisms are often recovered by microbiological methods, surgical pathologists play an invaluable role in diagnosis. The lower GI tract, including the appendix, large bowel, and anus, harbors a wide variety of pathogens. Some infections are part of disseminated disease, whereas others produce clinicopathologic scenarios that are specific to the lower GI tract. This review focuses on selected infectious disorders of the lower GI tract that may be encountered by the general surgical pathologist, including viral, bacterial, fungal, and parasitic organisms, and including infections caused by food- and water-borne pathogens. Diagnostic gross and histologic features are discussed, as well as useful clinical features and ancillary diagnostic techniques. Pertinent differential diagnoses are also emphasized, including other inflammatory conditions of the gut (such as ischemia or idiopathic inflammatory bowel disease) that can be mimicked by lower GI infections.
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Affiliation(s)
- Laura W Lamps
- Department of Pathology, University of Arkansas for Medical Sciences, 4301 West Markham Street, Shorey 4S/09, Little Rock, AR 72205, USA.
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Fatal amebic colitis after high-dose dexamethasone therapy for newly diagnosed multiple myeloma. Ann Hematol 2010; 90:225-6. [PMID: 20467744 DOI: 10.1007/s00277-010-0984-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 04/29/2010] [Indexed: 10/19/2022]
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41
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Koh PS, Roslani AC, Vimal KV, Shariman M, Umasangar R, Lewellyn R. Concurrent amoebic and histoplasma colitis: A rare cause of massive lower gastrointestinal bleeding. World J Gastroenterol 2010; 16:1296-8. [PMID: 20222177 PMCID: PMC2839186 DOI: 10.3748/wjg.v16.i10.1296] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later, the patient developed massive lower gastrointestinal bleeding with hemorrhagic shock. Emergency total colectomy with end-ileostomy was performed. However, he deteriorated and died on the second postoperative day. Histopathological examination revealed multiple deep ulcers at the hepatic flexure where fungal bodies of mycelial and yeast forms were noted. Isolated lymph nodes showed abscess formation with fungal bodies. Infective fungal colitis with Histoplasma capsilatum was diagnosed. In vitro, amoebic parasites can increase virulence and pathogenicity of histoplasma which may account for the fulminant presentation in this patient. Although rare, this unusual dual infection should be considered in the differential diagnosis of infective colitis, as appropriate antimicrobial treatment may prevent progression to massive lower gastrointestinal bleeding, obviating the need for urgent surgical intervention.
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Athié-Gutiérrez C, Rodea-Rosas H, Guízar-Bermúdez C, Alcántara A, Montalvo-Javé EE. Evolution of surgical treatment of amebiasis-associated colon perforation. J Gastrointest Surg 2010; 14:82-7. [PMID: 19774426 DOI: 10.1007/s11605-009-1036-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2009] [Accepted: 09/02/2009] [Indexed: 01/31/2023]
Abstract
BACKGROUND Amebiasis is a worldwide health problem that mainly affects developing countries. Invasive amebiasis tends to develop complications, and among these, perforation of the colon, although infrequent (1.9-9.1%), is the most lethal. Surgical treatment in these cases should be carried out in a timely fashion prior to the presentation of systemic repercussions or death. In the present study, we analyzed a total of 122 cases of invasive amebiasis-associated colon perforation. METHODS AND STUDY DESIGN We conducted a clinical, retrospective, and observational study and presented cases of colonic perforation observed over the past 30 years at the Medical-Surgical Emergency Service of the Mexico City-based Hospital General de México OD during the 1970-1999 period. RESULTS During this time, a total of 19,916 emergency abdominal surgeries were performed. One hundred twenty-two of these procedures corresponded to cases of colon perforation by ameba, which represents 0.6%; 80 patients were men (65.6%) and 42 were women (34.4%), with an average age of 48 years. Multiple colon perforation was 74%, with right colon the most affected (90.5%). Depending on the perforation's extension and localization, right hemicolectomy with ileostomy were performed in 53 patients (43.45%), subtotal colectomy with ileostomy in 43 (35.25%), left hemicolectomy with transverse colostomy in 12 (9.83%), exteriorization of perforated left colon (stoma) in 13 (10.65%), and primary closure with exteriorization in one patient (0.8%). Post-operative complications were present in 48 patients (39.3%), and 20 cases were related with the creation of a stoma. Eighteen of these cases were due to persistent abdominal sepsis and ten due to toxic colon; the latter correspond solely to patients with initial nonresective treatment. General mortality was 40%, with 32% (17 of 53 cases) of mortality in those submitted to right hemicolestomy, 16.7% (two of 12) of left hemicolestomy, 44.2% (19 of 43) in those in whom a subtotal colectomy was performed, with 76.9% (ten of 13) patients with exteriorization of the perforated right colon, and with 100% (one of one patient) mortality with primary closure. CONCLUSIONS Perforation is the most frequent surgical complication of invasive amebiasis of the colon, occurring principally in masculine gender and in the fourth decade of life. Resection and stoma creation is the procedure of choice that can resolve the septic focus from the first surgical procedure, depending on the general status of the patient. However, morbidity and mortality are high, and there is a tendency for these to be lower on comparing initial cases with those with recently conducted surgical procedures.
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Affiliation(s)
- César Athié-Gutiérrez
- Servicio de Cirugía General, Hospital General de México, Secretaría de Salud (SSA), Mexico City, Mexico,
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Singh A, Houpt E, Petri WA. Rapid Diagnosis of Intestinal Parasitic Protozoa, with a Focus on Entamoeba histolytica. Interdiscip Perspect Infect Dis 2009; 2009:547090. [PMID: 19584941 PMCID: PMC2703877 DOI: 10.1155/2009/547090] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 03/30/2009] [Indexed: 11/18/2022] Open
Abstract
Entamoeba histolytica is an invasive intestinal pathogenic parasitic protozoan that causes amebiasis. It must be distinguished from Entamoeba dispar and E. moshkovskii, nonpathogenic commensal parasites of the human gut lumen that are morphologically identical to E. histolytica. Detection of specific E. histolytica antigens in stools is a fast, sensitive technique that should be considered as the method of choice. Stool real-time PCR is a highly sensitive and specific technique but its high cost make it unsuitable for use in endemic areas where there are economic constraints. Serology is an important component of the diagnosis of intestinal and especially extraintestinal amebiasis as it is a sensitive test that complements the detection of the parasite antigens or DNA. Circulating Gal/GalNac lectin antigens can be detected in the serum of patients with untreated amoebic liver abscess. On the horizon are multiplex real-time PCR assays which permit the identification of multiple enteropathogens with high sensitivity and specificity.
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Affiliation(s)
- Anjana Singh
- University of Virginia, Charlottesville, P.O. Box 801340, VA 22908-1340, USA
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Eric Houpt
- University of Virginia, Charlottesville, P.O. Box 801340, VA 22908-1340, USA
| | - William A. Petri
- University of Virginia, Charlottesville, P.O. Box 801340, VA 22908-1340, USA
- Infectious Diseases and International Health, University of Virginia, MR4 Building, Health System, Charlottesville, VA 22908-1340, USA
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Lupi O, Bartlett BL, Haugen RN, Dy LC, Sethi A, Klaus SN, Machado Pinto J, Bravo F, Tyring SK. Tropical dermatology: Tropical diseases caused by protozoa. J Am Acad Dermatol 2009; 60:897-925; quiz 926-8. [PMID: 19467364 DOI: 10.1016/j.jaad.2009.03.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2008] [Revised: 10/05/2008] [Accepted: 03/07/2009] [Indexed: 11/18/2022]
Abstract
UNLABELLED Protozoan infections are very common among tropical countries and have an important impact on public health. Leishmaniasis is the most widely disseminated protozoan infection in the world, while the trypanosomiases are widespread in both Africa and South America. Amebiasis, a less common protozoal infection, is a cause of significant morbidity in some regions. Toxoplasmosis and pneumocystosis (formerly thought to be caused by a protozoan) are worldwide parasitic infections with a very high incidence in immunocompromised patients but are not restricted to them. In the past, most protozoan infections were restricted to specific geographic areas and natural reservoirs. There are cases in which people from other regions may have come in contact with these pathogens. A common situation involves an accidental contamination of a traveler, tourist, soldier, or worker that has contact with a reservoir that contains the infection. Protozoan infections can be transmitted by arthropods, such as sandflies in the case of leishmaniasis or bugs in the case of trypanosomiases. Vertebrates also serve as vectors as in the case of toxoplasmosis and its transmission by domestic cats. The recognition of the clinical symptoms and the dermatologic findings of these diseases, and a knowledge of the geographic distribution of the pathogen, can be critical in making the diagnosis of a protozoan infection. LEARNING OBJECTIVES After completing this learning activity, participants should be able to recognize the significance of protozoan infections worldwide, identify the dermatologic manifestations of protozoan infections, and select the best treatment for the patient with a protozoan infection.
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Affiliation(s)
- Omar Lupi
- Department of Dermatology at Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
BACKGROUND Entamoeba histolytica infection is common in developing countries, and up to 100,000 individuals with severe disease die every year. Adequate therapy for amoebic colitis is necessary to reduce the severity of illness, prevent development of complicated disease and extraintestinal spread, and decrease transmission. OBJECTIVES To evaluate antiamoebic drugs for treating amoebic colitis. SEARCH STRATEGY In September 2008, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (2008, Issue 3), MEDLINE, EMBASE, LILACS, mRCT, and conference proceedings. We contacted individual researchers, organizations, and pharmaceutical companies, and checked reference lists. SELECTION CRITERIA Randomized controlled trials of antiamoebic drugs given alone or in combination, compared with placebo or another antiamoebic drug for treating adults and children diagnosed with amoebic colitis. DATA COLLECTION AND ANALYSIS Two authors independently assessed the eligibility and methodological quality of trials, and extracted and analysed the data. We calculated clinical and parasitological failure rates, relapse, and adverse events as risk ratios (RR) with 95% confidence intervals (CIs), using a random-effects model. We determined statistical heterogeneity and explored possible sources of heterogeneity using subgroup analyses. We carried out sensitivity analysis using trial quality to assess the robustness of the results. MAIN RESULTS Thirty-seven trials, enrolling 4487 participants, met the inclusion criteria. Only one trial used adequate methods for randomization and allocation concealment, was blinded, and analysed all randomized participants. Only one trial used a E. histolytica stool antigen test. Tinidazole reduced clinical failure compared with metronidazole (RR 0.28, 95% CI 0.15 to 0.51; 477 participants, eight trials) and was associated with fewer adverse events. Compared with metronidazole, combination therapy resulted in fewer parasitological failures (RR 0.36, 95% CI 0.15 to 0.86; 720 participants, 3 trials). AUTHORS' CONCLUSIONS Tinidazole is more effective in reducing clinical failure compared with metronidazole and has fewer associated adverse events. Combination drug therapy is more effective in reducing parasitological failure compared with metronidazole alone. However, these results are based on trials with poor methodological quality so there is uncertainty in these conclusions. Further trials of the efficacy of antiamoebic drugs, with better methodological quality, are recommended. More accurate tests to detect E. histolytica are needed, particularly in countries where concomitant infection with other bacteria and parasites is common.
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Affiliation(s)
- Maria Liza M Gonzales
- Department of Pediatrics, College of Medicine-Philippine General Hospital, University of the Philippines, Taft Avenue, Manila, National Capital Region, Philippines, 1000.
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Abstract
Opportunistic gastrointestinal infections are common in patients with HIV infection; both amebic colitis and cytomegalovirus (CMV) colitis are common causes of chronic diarrhea. It is difficult to distinguish these 2 diseases by nonspecific clinical symptoms such as diarrhea, abdominal pain, and weight loss. Here we report a case of CMV colitis mimicking amebic colitis with elevated indirect hemagglutination assay antibody titer against Entamoeba histolytica and negative IgM antibody titer against CMV. The diagnosis of CMV colitis was confirmed by eosinophilic nucleoli and inclusion bodies in colon biopsies. The patient recovered after ganciclovir and highly active antiretroviral therapy. Exact diagnoses are important for treating opportunistic infections. Other pathogens should be considered in patients with chronic diarrhea who are refractory to initial treatments. Our case highlights the importance of histopathological diagnosis for chronic diarrhea in patients with HIV infection and the possibility of false-positive results for indirect hemagglutination assay antibody against Entamoeba histolytica despite high titers.
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Sayhan Emil S, Altinel D, Bayol U, Ozcolpan OO, Tan A, Ganiusmen O. Amebic cerebral abscess mimicking bacterial meningitis. Indian J Pediatr 2008; 75:1078-80. [PMID: 18810346 DOI: 10.1007/s12098-008-0182-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 02/18/2008] [Indexed: 11/26/2022]
Abstract
We report a case of an amebic brain abscess in a 2-year-old girl, with symptoms mimicking bacterial meningitis with no evidence of disease elsewhere. Histological evaluation of the abscess revealed the organisms, and the abscess regressed in response to specific medical treatment. This article reviews the rarity of these abscesses and difficulty in the diagnosis.
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Affiliation(s)
- S Sayhan Emil
- Department of Pathology, RTMH Izmir Tepecik Teaching Hospital, Clifton, Atlanta, GA, USA
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Immune responses to protozoans. Clin Immunol 2008. [DOI: 10.1016/b978-0-323-04404-2.10028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abd El Bagi M. Imaging of Parasitic Diseases of the Gastrointestinal Tract. IMAGING OF PARASITIC DISEASES 2007:73-102. [DOI: 10.1007/978-3-540-49354-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Franco-Paredes C, Rouphael N, Méndez J, Folch E, Rodríguez-Morales AJ, Santos JI, Hurst JW. Cardiac manifestations of parasitic infections part 3: pericardial and miscellaneous cardiopulmonary manifestations. Clin Cardiol 2007; 30:277-80. [PMID: 17551959 PMCID: PMC6653132 DOI: 10.1002/clc.20092] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This is part three of a three-part series discussing parasites of the heart. In this section, we present an overview on parasitic diseases involving predominantly the pericardium and other miscellaneous cardiopulmonary manifestations such as some pulmonary hypertension syndromes and endomyocardial fibrosis.
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Affiliation(s)
- Carlos Franco-Paredes
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30303, USA.
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