It can be diagnosed by stool samples, but it is important to note that certain other species are impossible to distinguish by microscopy

alone. Trophozoites may be seen in a fresh fecal smear and cysts in an ordinary stool sample. ELISA or RIA can also be used. Genus and Species Etiologic Agent of: Definitive Host Mode of Transmission Pathogenesis Entamoeba histolytica Amoebiasis; Amoebic dysentery; Extraintestinal Amoebiasis, usually Amoebic Liver Abscess = anchovy sauce); Amoeba Cutis; Amoebic Lung Abscess (liver-colored sputum) Human Ingestion of mature cyst through contaminated food or water Lytic necrosis (it looks like flask-shaped holes in Gastrointestinal tract sections (GIT) Most common is Direct Fecal Smear (DFS) and staining (but does not allow identification to species level); Enzyme immunoassay (EIA); Indirect Hemagglutination (IHA); Antigen detection monoclonal antibody; PCR for species identification. Sometimes only the use of a fixative (formalin) is effective in detecting cysts. Culture: From faecal samples - Robinson's medium, Jones' medium Metronidazole for the invasive trophozoites PLUS a lumenal amoebicide for those still in the intestine. Paromomycin (Humatin) is the luminal drug of choice, since Diloxanide furoate (Furamide) is not commercially available in the USA or Canada (being available only from the Centers for Disease Control and Prevention). A direct comparison of efficacy showed that Paromomycin had a higher cure rate.[10] Paromomycin (Humatin) should be used with caution in patients with colitis, as it is both nephrotoxic and ototoxic. Absorption through the damaged wall of the intestinal tract can result in permanent hearing loss and kidney damage. Recommended dosage: Metronidazole 750 mg tid orally, for 5 to 10 days FOLLOWED BY Paromomycin 30 mg/kg/day orally in 3 equal doses for 5 to 10 days or Diloxanide furoate 500 mg tid orally for 10 days, to eradicate lumenal amoebae and prevent relapse.[11]

Lab Diagnosis

Treatment

Amebiasis (amebic dysentery)

Who gets amebiasis?
Anyone can get amebiasis, but it is recognized more often in people arriving from tropical or subtropical areas, individuals living in institutions, and men who have sex with men.

How is amebiasis spread?

Amebiasis is contracted by consuming contaminated food or water containing the cyst stage of the parasite. It can also be spread by person-to-person contact.

How soon after exposure do symptoms appear?

The symptoms may appear from a few days to a few months after exposure but usually within two to four weeks.

For how long can an infected person carry this parasite?

Some people with amebiasis may carry the parasite for weeks to years, often without symptoms.

How is it diagnosed?
Examination of stools under a microscope is the most common way for a doctor to diagnose amebiasis. Sometimes, several stool samples must be obtained because the number of amoeba being passed in the stool, which varies from day to day, may be too low to detect from any single sample.

What is the treatment for amebiasis?

Specific antibiotics such as metronidazole can be prescribed by a doctor to treat amebiasis.

What precautions should the infected person follow?

The most important precautions are careful handwashing after each toilet visit and proper disposal of sewage. Homosexual males should refrain from intimate contact until effectively treated.

botulism (food-borne botulism and infant botulism)

What is botulism?Botulism is a serious illness caused by a nerve toxin made by the
bacterium, Clostridium botulinum. (A toxin is a poison that is released by some bacteria). There

How is it spread?Botulism is most often caused by bacteria that have produced the
toxin in a wound or in food. Person-to-person spread does not occur.

How soon after exposure would symptoms develop?

Symptoms generally begin 12-36 hours after eating contaminated food, but may occur as early as a few hours and as late as 10 days.

What is the treatment?

The symptoms of botulism make hospitalization necessary. If diagnosed early, botulism can be treated with an antitoxin, which blocks the action of the toxin circulating in the blood. This can prevent patients from worsening, but recovery still takes many weeks. If left untreated, a patient may need to be on a breathing machine (ventilator) for weeks and would require intensive medical and nursing care. Infant botulism is treated with immune globulin, which is similar to the antitoxin. Most cases of botulism recover with appropriate medical care.

Can botulism be prevented?

All canned and preserved foods should be properly processed and prepared. Persons who do home canning should follow strict hygienic procedures to reduce contamination of foods. Because the botulism toxin is destroyed by high temperatures, persons who eat home-canned foods should consider boiling the food for 10 minutes before eating it to ensure safety. Bulging containers should not be opened and foods with an unusual smell should not be eaten or even tasted. Canned food with bulging lids should be thrown away. Identified sources of infant botulism, such as honey, should not be fed to infants.

chickenpox?
Chickenpox is a highly contagious illness caused by the varicella-zoster virus (VZV), a type of herpes virus. Chickenpox is a common childhood illness with 90 percent of the cases occurring in children younger than ten years of age. Before the availability of the varicella vaccine in the U.S., almost everyone developed chickenpox. Most people who are vaccinated will not get chickenpox. Those who are vaccinated and develop chickenpox usually have a mild form of the illness. They have fewer spots and recover faster.

How is chickenpox spread?

Chickenpox is transmitted from person to person by directly touching the blisters, saliva or mucus of an infected person. The virus can also be transmitted through the air by coughing and sneezing. Chickenpox can be spread indirectly by touching contaminated items freshly soiled, such as clothing, from an infected person. Direct contact with the blisters of a person with shingles can cause chickenpox in a person who has never had chickenpox and has not been vaccinated. Blisters that are dry and crusted are no longer able to spread chickenpox.

How soon do symptoms appear?

Symptoms commonly appear 14 to 16 days (range of ten to 21 days) after exposure to someone with chickenpox or herpes zoster (shingles).

When and for how long is a person able to spread chickenpox?

A person is most able to transmit chickenpox from one to two days before the rash appears until all the blisters are dry and crusted. People with a weakened immune system may be contagious for a longer period of time.

Is there a treatment for chickenpox?

Acyclovir is approved for treatment of chickenpox. However, because chickenpox tends to be mild in healthy children, most physicians do not feel that it is necessary to prescribe acyclovir. Acyclovir can be considered for otherwise healthy people who are at risk of moderate to severe varicella. It is important to consult with your physician for recommendations on the use of acyclovir.

Is there a vaccine for chickenpox?

A vaccine to protect children against chickenpox was first licensed in 1995. Children who have never had chickenpox should routinely be administered two doses of varicella vaccine with the first dose at 12 to 15 months and the second dose at four to six years of age. Persons 13 years of age and older who have never had chickenpox or have not received the varicella vaccine should get two doses of the varicella vaccine at least 28 days apart. The varicella vaccine may be given along with the measles-mumps-rubella (MMR) vaccine in a combination called measles-mumps-rubella-varicella (MMRV) that is approved for use in children 12 months through 12 years of age. In New York State, varicella vaccine is required for children enrolled in pre-kindergarten programs and schools. Vaccination is recommended for healthcare personnel and college students who have never had chickenpox.
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