Main » Infectious diseases » Infections Acquired through the Gastro-intestinal Tract » Amoebiasis
Photo 1. Macroscopic appearance of stool. In amoebic dysentery the stool is loose, containing mucus and blood mixed with faecal material. As distinct from bacterial dysentery there is no cellular exudate.
Photo 2. Living E. histolytica. Rather rapidly moving trophozoites of Entamoeba histolytica containing ingested erythrocytes may be found in a freshly passed specimen. (x 900)
Photo 3. Sites of predilection. The commonest sites for localisation of E. histolytica in the intestine are the caecum and descending colon.
Photo 4. Amoebic ulceration of caecum. In fulminating infections, the destruction of all layers of the intestinal wall is extensive, and ulceration may be confluent. These lesions are frequently seen in pregnancy and the puerperium.
Photo 5. Section of colon wall as seen in biopsy. Typical 'flask-shaped' ulcers are seen in the intestinal wall which is invaded by E. histolytica trophozoites. The intervening mucosa is usually normal. (x 150)
Photo 6. Temperature chart of patient with amoebic liver abcess. The triad of swinging temperature, profuse sweats and leucocytosis is indicative of liver abscess, especially when associated with pain in the right hypochondrium.
Photo 7. Scintoscan of patient with amoebic liver abscess. The liver is often enlarged and tender, sometimes bulging in the abscess area.
Photo 8. X-ray of liver abscess. An amoebic abscess of the liver is usually single. The volume of the contents of the lesion may vary from 500 to 1500 ml.
Photo 9. Aspiration of liver abscess. Aspiration of large abscesses is usually needed as an adjunct to specific chemotherapy for successful treatment.
Photo 10. Amoebic pus. The pus is chocolate-coloured. Trophozoites usually containing ingested red blood cells may be found in the pus if it is examined immediately after aspiration.
Photo 11. Macroscopic appearance of liver abscess. The shaggy periphery is irregular and consists of stroma and layers of compressed liver parenchyma.
Photo 12. Section of liver abscess. E. histolytica are often found in large numbers in the tissue at the periphery of the lesion, (x 150)
Photo 13. Amoebic abscess of lung. Extraintestinal infections occur commonly in the liver, but any site of the body may be affected. The lung is sometimes affected by rupture of a hepatic abscess through the diaphragm. Typical amoebic pus may be coughed up with the sputum.
Photo 14. Amoebiasis of the skin. Amoebic infection of the skin occurs. This patient was erroneously operated on for a perforated duodenal ulcer and no antiamoebic drugs were given. Sloughing of the skin occurred and amoebae were recovered from the skin lesion.
Photo 15. Amoebic balanitis. Amoebic infection of the genital organs can result frorr normal or abnormal sexual intercourse.
Photo 16. Fluorescent antibody staining of E. histolytica. FAT is the most sensitive immunodiagnostic test available for invasive forms of amoebiasis. It has proved a valuable adjunct to direct microscopical diagnosis of amoebiasis. Ruorescence of cultured E. histolytica exposed to serum from a patient with hepatic involvement is seen in this figure. (X 900)
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