• Genka Ikumi
    AIDS Clinical Center, International Medical Center of Japan

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  • 赤痢アメーバ症

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Abstract

Amebiasis caused by ingestion of cysts of the protozoan parasite Entamoeba histolytica through fecally contaminated food develops when cysts pass through the stomach and are excystated in the small bowel, forming trophozoites in the large bowel. Some trophozoites invade the colon mucosa, produce ulcers, and cause amebic colitis. Others invade the portal vein, lodge in the liver, and form a liver abscess. Amebic infection is much more common in tropical developing nations. In industrialized countries, travelers from developing countries, residents of the mental institutions, and men who have sex with men (MSM) are at increased risk for amebiasis.Invasive amebiasis, e. g., colitis and liver abscesses, should be treated with metronidazole, which is effective for all tissues and usually engenders an effective response. Metronidazole therapy is followed by paromomycin, or diloxanide furoate, which are non absorbed luminal agents that prevent relapse by eradicating residual cysts in the colon. Luminal agents are not approved in Japan, but are provided by the Research Group on Chemotherapy of Tropical Diseases, which is part of the Research on Health Sciences Focusing on Drug Innovation, supported by the Japan Health Sciences Foundation. Early diagnosis and treatment of amebiasis is important when clinicians see watery and bloody diarrhea, abdominal pain, and fever in travelers from developing countries or in MSM patients.

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