A clinical syndrome suggestive of intestinal disease was first widely recognized in the mid-1800s, although a parasitic etiology was not determined at that time. In 1828, James Annesley first hinted at an association of dysentery and liver abscess, stating “… hepatic disease seems to be induced by the disorder of the bowels” ( 107). histolytica sensu strictu) from nonpathogenic ( E. histolytica and amebiasis were its description by Losch in 1873, the delineation of amebic liver abscess and colitis by Osler and his colleagues in 1890, its axenic culture by Diamond in 1961, and differentiation of pathogenic ( E. histolytica research has been reviewed by Kean ( 107) and by Clark et al. Later, the Old Testament and Huang Ti's Classic in Internal Medicine (140 to 87 B.C.) made reference to dysentery ( 107). histolytica, discuss what differentiates it from other Entamoeba species, and discuss recent advances in the diagnosis and management of amebiasis.Īmebiasis may have been first recognized as a deadly disease by Hippocrates (460 to 377 B.C.), who described a patient with fever and dysentery. The goals of this review are to describe E. Each detection test has different advantages and disadvantages. Microscopy, culture/zymodeme analysis, and molecular biology-based techniques are used for the diagnosis of E. dispar due to limited data obtained from microscopic examinations. histolytica infections were most probably confused with E. It is very important to keep in mind that according to the older data, many E. histolytica), but they have a high degree of divergence ( 41, 43, 218). ![]() ![]() In the light of earlier reports about the prevalence of amebiasis in such subjects, interpretation is very difficult because older data did not differentiate between morphologically identical species, one that is noninvasive ( E. bütschlii have occasionally been implicated as causes of diarrheal illness in humans ( 33, 34, 47, 103, 153). However, these are generally accepted as commensal organisms except for E. polecki, Iodamoeba bütschlii, and Endolimax nana) which live in the human intestinal lumen ( 40, 64, 65, 80, 116). moshkovskii are nonpathogenic and noninvasive parasites that are identical morphologically to E. ![]() histolytica is a pathogen or invasive parasite, whereas E. histolytica infection during a 1-year study ( 81).Į. For example, it was observed that 39% of children from an urban slum in Dhaka, Bangladesh, had a new E. The vast majority of these infections are acquired in the developing world. histolytica causes approximately 50 million cases and 100,000 deaths annually ( 13, 229). The World Health Organization reported that E. This is because amebiasis is presently one of the three most common causes of death from parasitic disease. The detection of Entamoeba histolytica, the causative agent of amebiasis, is an important goal of the clinical microbiology laboratory. All the current tests suffer from the fact that the antigens detected are denatured by fixation of the stool specimen, limiting testing to fresh or frozen samples. On the other hand, stool antigen detection tests offer a practical, sensitive, and specific way for the clinical laboratory to detect intestinal E. The detection of amebic markers in serum in patients with amebic colitis and liver abscess appears promising but is still only a research tool. In all cases, combination of serologic tests with detection of the parasite (by antigen detection or PCR) offers the best approach to diagnosis, while PCR techniques remain impractical in many developing country settings. Molecular biology-based diagnosis may become the technique of choice in the future because establishment of these protozoa in culture is still not a routine clinical laboratory process. histolytica, there is great potential for further understanding the pathogenesis of amebiasis. As more is discovered about the molecular and cell biology of E. histolytica infection, it is necessary to utilize accurate diagnostic tools.
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