CDC - DPDx - Amebiasis

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http://www.cdc.gov/dpdx/amebiasis/index.html

Parasites A-Z
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About DPDx
DPDx is an education resource designed for health professionals and laboratory scientists. For an
overview including prevention and control visit www.cdc.gov/parasites/amebiasis.

[Entamoeba histolytica]
Parasite Biology
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Laboratory Diagnosis
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Cyst of E. histolytica/E. dispar stained with trichrome. Note the chromatoid body with blunt ends (red arrow).

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http://www.cdc.gov/dpdx/amebiasis/index.html

Trophozoites of E. histolytica with ingested erythrocytes stained with trichrome. The ingested erythrocytes appear as dark inclusions. The parasite above show
nuclei that have the typical small, centrally located karyosome, and thin, uniform peripheral chromatin.

Entamoeba histolytica trophozoites in colon tissue stained with H&E.

Causal Agents
Several protozoan species in the genus Entamoeba colonize humans, but not all of them are
associated with disease. Entamoeba histolytica is well recognized as a pathogenic ameba,
associated with intestinal and extraintestinal infections. The other species are important because
they may be confused with E. histolytica in diagnostic investigations.

Life Cycle

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Cysts and trophozoites are passed in feces . Cysts are typically found in formed stool, whereas
trophozoites are typically found in diarrheal stool. Infection by Entamoeba histolytica occurs by
ingestion of mature cysts in fecally contaminated food, water, or hands. Excystation occurs
in the small intestine and trophozoites are released, which migrate to the large intestine. The
trophozoites multiply by binary fission and produce cysts , and both stages are passed in the
feces . Because of the protection conferred by their walls, the cysts can survive days to weeks in
the external environment and are responsible for transmission. Trophozoites passed in the stool
are rapidly destroyed once outside the body, and if ingested would not survive exposure to the
gastric environment. In many cases, the trophozoites remain confined to the intestinal lumen ( :
noninvasive infection) of individuals who are asymptomatic carriers, passing cysts in their stool.
In some patients the trophozoites invade the intestinal mucosa ( : intestinal disease), or, through
the bloodstream, extraintestinal sites such as the liver, brain, and lungs ( : extraintestinal
disease), with resultant pathologic manifestations. It has been established that the invasive and
noninvasive forms represent two separate species, respectively E. histolytica and E. dispar. These
two species are morphologically indistinguishable unless E. histolytica is observed with ingested
red blood cells (erythrophagocystosis). Transmission can also occur through exposure to fecal
matter during sexual contact (in which case not only cysts, but also trophozoites could prove
infective).

Geographic Distribution
Worldwide, with higher incidence of amebiasis in developing countries. In industrialized
countries, risk groups include male homosexuals, travelers and recent immigrants, and
institutionalized populations.

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Clinical Presentation
A wide spectrum, from asymptomatic infection ("luminal amebiasis"), to invasive intestinal
amebiasis (dysentery, colitis, appendicitis, toxic megacolon, amebomas), to invasive extraintestinal
amebiasis (liver abscess, peritonitis, pleuropulmonary abscess, cutaneous and genital amebic
lesions).
For questions about DPDx, contact us
Page last reviewed November 29, 2013
Page last updated November 29, 2013
Content source: Global Health - Division of Parasitic Diseases and Malaria
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