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8/6/2019 NI Presentation

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Amoebiasis is a protozoalinfection of human beings initiallyinvolves the colon, but mayspread to soft tissues, mostcommonly to the liver or lungs, by

contiguity or hematogenous oflymphatic dissemination.


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Entamoeba HistolyticaPrevalent in unsanitary areas

Common in warm climate

Acquired by swallowing

Cyst survives a few days outside of the body

Cyst passes to the large intestine and hatch intothe trophozoites. It passes to the mesenteric veins,to the portal vein, to the liver, thereby formingamoebic liver abscess.


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Two Developmental Stages

1. Trophozoites/vegetative form

These are facultative parasites that may invade the tissues ormay be found in the parasitized tissues and liquid colonic

contents.2. Cyst

It is passed out with formed or semi-formed stools and areresistant to environmental conditions.

This is considered as the infective stage in the life cycle of E.histolytica.


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Ingestion of Bacteria

Multiplication in mucosa

Endotoxin production affecting the lining of

the small intestines, colon, and capillaryNecrosis of the mucosal layer

Ulceration

Gangrene

TOXEMIA


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Clinical Manifestations1. Acute Amoebic Dysentery Slight attack of diarrhea, altered with periods of

constipation and often accompanied by tenesmus

Diarrhea, watery and foul-smelling stool oftencontaining blood-streaked mucus

Colic and gaseous distention of the lower abdomen

Nausea, flatulence, abdominal distention andtenderness in the right iliac region over the colon


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2. Chronic Amoebic Dysentery Attack of dysentery that lasts for several days, usually succeeded by

constipation Tenesmus accompanied by the desire to defecate Anorexia, wt. loss, and weakness Liver may be enlarged The stool at first is semi fluid but soon becomes watery, bloody and mucoid

Vague abdominal distress, flatulence, constipation or irregularity of bowel. Mild toxemia, constant fatigue, and lassitude Abdomen loses its elasticity when picked-up between fingers On sigmoidoscopy, scattered ulceration with yellowish and erythematous

border

Gangrenous type (fatal cases) is characterized by the appearance of largesloughs of intestinal tissues in the stool accompanied by hemorrhage


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3. Extraintestinal forms

Hepatic

a. pain at the URQ with tenderness of the liver

b. Jaundice

c. Intermittent fever

d. Loss of weight or anorexia

e. Abscess may break through the lungs, patients coughs

anchovy-sauce sputum


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Clinical Features1. Onset is gradual

2. Diarrhea increases and stool besomesbloody and mucoid

3. Abscesses in the skin

4. In extreme cases liver abscessesif theinfection goes to the bloodstream


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Nursing Management

1. Observe isolation and enteric precaution2. Provide health education and instruct the patient

to:

a. Boil water for drinking or use purifies water;

b. Avoid washing food from open drum or pail;

c. Cover left-over food;

d. Wash hands after defecation or before eating; and

e. Avoid ground vegetables (lettuce, carrots, and thelike)


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Prevention Methods1. Sanitary disposal of feces

2. Protect, chlorinate and purify drinking water

3. Observe scrupulous cleanliness in foodpreparation and food handling

4. Detection and treatment of carriers5. Fly control


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