Amoebic dysentery

Latest update: - Authors: Mieke Croughs, Ula Maniewski-Kelner

Amoebic dysentery or amoebiasis is a serious infection of the intestines, caused by the parasite Entamoeba histolytica.

Infection occurs via contaminated water or food, or through direct contact with infected stools. The risk of amoebiasis is greater for adventurous travellers, for migrants visiting their country of origin and for individuals with reduced immunity.

The following symptoms can occur several days to weeks after the infection:

  • Abdominal or rectal cramping with some discharge containing mucous, puss or blood.
  • Diarrhoea with mucous or blood.
  • Frequent small quantities of stool with mucous.
  • Usually little or no fever.
  • False need to pass stools (only the sensation that a bowel movement is starting).
  • The course of the disease is sometimes severe, with high fever and bleeding in the intestines.

The symptoms can persist for weeks.

Risk areas

Amoebiasis occurs all over the world, but the risk is higher in the tropics, particularly in poor hygienic conditions.

Prevention

Food and drink

Measures to ensure safe consumption of food and drinks will reduce the risk.

Vaccination

There is no vaccine available.

In case of symptoms

Seek medical advice if you suffer any symptoms.

Treatment of amoebic dysentery

Tinidazole (Fasigyn®):

  • Adults: four tablets of 500 mg taken in one dose for one to three days, depending on the severity.
  • Children:  50 mg per kg once per day for three to five days.
  • This medication should not be combined with alcohol.

Metronidazole is also an option, but causes more side effects and the effect is slower. Ornidazole is a good alternative.

Always followed by:

Paromomycin (Gabbroral®):

  • Adults: 500 mg three times per day (two tablets three times per day, three boxes) for eight days.
  • Children: 10 mg per kg three times per day for seven to ten days.

Seek medical assistance if the symptoms do not improve within 48 hours. You may require antibiotics.

Also refer to the treatment of traveller’s diarrhoea.

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