1/72. Multifocal omental mesenteric inflammatory pseudotumor (plasma cell granuloma). Inflammatory pseudotumor (IP) is an uncommon benign tumor during childhood. The most common location is lung, and sporadic cases of IP with extrapulmonary involvement such as liver and abdomen are reported. However, the IP among the reported cases have appeared as solitary masses. A multifocal IP in a 14-year-old girl presumed to result following an entamoeba histolytica infestation is reported. ( info) |
2/72. Symptomatic and asymptomatic amoebiasis in two heterosexual couples. Four cases of amoebiasis are described: two symptomatic with intestinal and hepatic involvement and two asymptomatic, diagnosed in two, heterosexual, Italian couples. Infection was probably acquired first by the men, via an indirect faccal-oral route, and then transmitted to their partners in the same way. The two amoebic strains isolated, from the woman of one couple and the man of the other, were characterized by electrophoresis as zymodemes II alpha- and XIX of entamoeba histolytica. These four cases emphasise once more the role of cyst-passers in the spread of infection and the importance of biochemical identification of the amoebic isolates, enabling more specific treatment. ( info) |
| liver abscesses are the most common manifestation of extraintestinal infection by entamoeba histolytica. Involvement of other sites, including the peritoneum, pericardium, brain, or genitourinary tract, is unusual. We describe a case of inguinal necrotizing lymphadenitis caused by E histolytica. Our patient responded well to surgical drainage, metronidazole, and paramomycin therapy. A literature review of genitourinary and other uncommon sites of E histolytica infection is included. ( info) |
| Human-to-human transmission of entamoeba histolytica is rare in industrialized countries. We describe an outbreak of amebiasis in a family in The netherlands, demonstrating that even with Western standards of hygiene, persistent cyst passage may result in the transmission of E. histolytica to household contacts. If E. histolytica is isolated from a person living in an area of nonendemicity, it may be worthwhile to test all family members for cyst passage. ( info) |
5/72. Intestinal amebiasis: a diagnosis not to be missed. entamoeba histolytica is a well-recognized cause of infectious colitis and disseminated amebic abscesses. Most prevalent in the tropics and subtropics, E. histolytica infections may also occur in the developed world. We describe a case of a North American traveler with intestinal amebiasis, a diagnosis first made by colonic biopsy. We review the available diagnostic tools and the role of the surgical pathologist in the detection of this infection. ( info) |
6/72. Amebic abscess of urachal remnants. We report a rare case of amebic abscess of the urachus, mimicking an urachal neoplasm: no previous reports of amebic infection of the urachus were found in the literature. The challenges of the differential diagnosis between urachal abscess and carcinomas based both on clinical and radiological data are discussed. ( info) |
7/72. Asymptomatic amoebic infection: entamoeba histolytica or Entamoeba dispar? That is the question. Two cases of amoebic infection were diagnosed in a heterosexual couple. The cases, a Frenchman with previous trips to various African countries and his sexual partner, a Cameroonese woman immigrant living outside the community, were both asymptomatic; the infection had been diagnosed by chance in the man at the time of his employment in a hospital kitchen. Based on what is known of the epidemiology of amoebic infection, it may be acquired and then transmitted within a couple via the indirect faecal-oral route or, in greater likelihood, by sexual practices. Both amoebic isolates were characterised by isoenzyme electrophoresis as non-pathogenic Entamoeba dispar, zymodemel. Other diagnostic tools, such as ELISA direct stool antigen detection tests and serological assays were employed, confirming the diagnosis of E. dispar infection. Given there are a number of asymptomatic cyst passers of entamoeba histolytica, besides human carriers of saprophyte E. dispar, we stress the importance of applying, when possible, advanced protocols of diagnosis to distinguish the microscopically identical pathogenic species from the non-pathogenic one. ( info) |
8/72. Diagnostic dilemma in coinfection. A Fifteen years girl belonging to a low socioeconomic status was admitted with peritonsillar abscess caused by methicillin resistant staphylococcus aureus (MRSA), high fever, diarrhoea and septicaemic shock. Initial blood cultures and widal test, stool cultures and routine stool examination were non-contributory to the diagnosis. A bone marrow culture in the second week confirmed the diagnosis of salmonella typhi infection. Examination of a fresh stool sample showed cysts of entamoeba histolytica. She was treated with ciprofloxacin, metronidazole, augmentin and ceftriaxone. She had no clinical evidence of immunosuppression prior to this episode and her hiv test was negative. This case report highlights the presence of community acquired MRSA infection causing perititonsillar abscess, and the diagnostic dilemma of fever and diarrhoea due to coinfection with salmonella typhi and Entamobea histolytica. ( info) |
| We describe the pathology of a unique case of Fallopian tube amebiasis, associated with hydrosalpinx, in a 21-year-old woman. She complained of lower abdominal pain, had a foul-smelling green vaginal discharge and fever during one week. There was a discrete increase in body temperature and a painful abdominal palpation at the lower right side, with signs of local peritoneal irritation. Pathological examination showed a marked dilatation of the fallopian tube and hydrosalpinx. Microscopic examination showed a poorly formed granuloma composed of large macrophages with many entamoeba histolytica trophozoites inside the fallopian tube. Even though it is a rare disease the correct diagnosis of female genital tract amebiasis is of great importance for the indication of proper therapy. ( info) |
10/72. A patient with intestinal amoebiasis and cutaneous amoebic ulcer. This paper reports a patient with intestinal amoebiasis in concomitant with amoebic ulcer in the thigh. The ulcer was suspected to be carcinoma, complicated cutaneous leishmaniasis or due to free-living amoebae. The diagnosis was confirmed by the pathological and parasitological demonstration of haematophagous trophozoites of E. histolytica. The patient was successfully treated with metronidazole. ( info) |