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Amoebiasis
(Amoebic Dysentery)
A protozoal infection of man initially involving
the colon but may spread to soft tissues by
contiguity or hematogenous or lymphatic
dissemination most commonly to the liver or
lungs.
Is the third leading cause of death from
parasitic disease worldwide.
Êti l gic ge t
(Ê ta e a Hyst litica)
Prevale t i ill- Cyst survive a few
sa itated areas days utside the dy
Cyst pass t the large
C i war i testi e a d hatch
cli ate i t tr ph zites. Pass
 cquired y i t ese teric vei s,
t the p rtal vei , t
swall wi g
the liver, there y
f r i g a e ic liver
a scess.
?wo developmental stages
1. ?rophozoites/vegetative 2. Cyst
form ¢ Are passed out with
¢ A facultative parasite forms or semi-formed
that may invade tissue stools and are resistant
or they are found in to environmental
the parasitized tissues conditions.
and liquid colonic ¢ Considered as the
contents. infective stage in the life
cycle of Êntamoeba
ystolitica
r
 
‘  

 
40 days in severe 4Yor duration of the
infection; several illness.
months in sub-
acute and chronic
form. In average
case vary from 0-4
weeks.
Œode of transmission

ΡYecal-oral transmission
ΡDirect contact
ΡIndirect contact- by ingestion of food
especially uncooked leafy vegetables or
contaminated with fecal material
containing Ê. ystolitica cycts.
Clinical manifestation
A. Acute amoebic dysentery
4 Slight attack of diarrhea, altered
with periods of constipation and
often accompanied by tenesmus.
4 Diarrhea, watery and foul-
smelling stools often containing
blood-streaked mucus.
4 Diarrhea, watery and foul-
smelling stools often containing
blood-streaked mucus.
4 Nausea, flatulence and
abdominal distension, and
tenderness in the right iliac
region over the colon.
ë. Chronic amoebic dysentery
4 Attack of dysentery lasting for several
days, usually succeeded by constipation.
4 ?enesmus accompanied by the desire to
defecate.
4 Anorexia, weight loss and weakness.
4 Liver maybe enlarged.
4 ?he stools at first are semi-fluid but soon
become watery, blood, and mucoid.
4 Vague abdominal distress, flatulence,
constipation or irregularity of the bowel.
4 Œild anorexia, constant fatigue and
lassitude
4 Abdomen lost its elasticity when picked---
up between fingers.
4 On sigmoidoscopy, scattered ulceration
with yellowish and erythematous border.
4 Gangrenous type of stool
Êxtra intestinal forms
è epatic
4 Pain at the upper right
quadrant with
tenderness of the liver.
4 Jaundice
4 Intermittent fever
4 Loss of weight or
anorexia
4 Abscess may break
through the lungs,
patient coughs
anchovy-sauce sputum
?reatment
Diagnostic exam
modalities
Stool exam Œetronidazole
ëlood exam ?etracycline
Ampicillin, quinolones,
Proctoscopy/ sulfadiazine
sigmoidoscopy Streptomycin
Yluid and electrolytes
lost should be
replaced
Nursing management
1. Isolation, enteric
precaution
2. ealth education
¢ ëoil water for drinking or
use of purified water
¢ Avoid washing food from
open drum or pail
¢ Cover leftover food
¢ Wash hands after
defecation or before eating
¢ Avoid eating raw ground
vegetables (lettuce,
carrots, etc.)
Œethods of Prevention
Ⱥ ealth education
Ⱥ Sanitary disposal of feces
Ⱥ Protect, chlorinate and
purify drinking water
Ⱥ Use scrupulous
cleanliness in food
preparation, handling,
and storage
Ⱥ Detection and treatment
of carriers
Ⱥ Yly control
ëacillary Dysentery
(shigellosis; bloody flux)
An acute bacterial infection of the
intestine characterized by diarrhea,
and fever associated with the passing
out of bloody-mucoid stools with
tenesmus.
Êtiologic agent
Your serologic groups

D Shigella flesneri
D Shigella boydii
D Shigella connie
D Shigella dysentery
¢ ?he most infectious
¢ abitat is the GI? of man
¢ Develop resistance against antibiotics
¢ Invade in the blood stream
‘ ‘ 
‘
4 ‰ hours to ‰ days with the average of 0-5 days

‘   ‘‘‘
D?he patient is capable of transmitting the
microorganism during the acute infection until feces
is negative for the microorganism. Some patient
remain a carrier for a year or two.
  
 ‘‘
ÚIngestion of contaminated food, or drink
M?ransmitted by flies
Yecal-oral transmission
Clinical manifestation

è Yever
è ?enesmus, nausea,
vomiting and headache
è Colicky or cramping
abdominal pain with
anorexia and body
weakness
è Diarrhea with bloody-
muciod stools
è Dehydration and loss of
weight
Complications

è Rectal prolapse
è Respiratory
complication
è Non-suppurative
arthritis and
peripheral
neuropathy
CYCLÊ
¢S IGÊLLA YLÊSNÊRÊ
¢S IGÊLLA ëOYDII
¢ S IGÊLLA CONNÊI
¢S IGÊLLA DYSÊN?ÊRY

UŒAN YACÊAL
ŒAN POLLU?ION

INGÊS?ION OY YÊCÊS
ŒICROORGANISŒ

YÊCAL-ORAL
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Π  
 
üYecalysis üAntibiotics
üIsolation of the üIV infusion with NSS
causative üLow residue of diet
microorganism from üAnti diarrheal drugs
rectal swab
üPeripheral blood
examination
üëlood culture
üSheets of
polymorphoneuclear
leukocytes
NURSING ŒANAGʌÊN? ŒÊ?ODS OY
ڌaintain fluid and PRÊVÊN?ION AND
eletrolyte balance CON?ROL
ÚRestrict food until Sanitary disposal of
nausea and vomiting human feces
subsides Sanitary supervision of
ÚIsolation processing, preparation
ڌaintain personal of food
hygiene Yly control
ÚProper disposal of Isolation of patient
excreta
ÚConcurrent and terminal
disinfection