Abstract:
Amebiasis, which is caused by Entamoeba histolytica (E. histolytica), is the second leading cause of parasite-related death worldwide. It manifests from asymptomatic carriers to severe clinical conditions, like colitis and liver abscesses. Amebiasis is commonly seen in developing countries, where water and food are easily contaminated by feces because of the poor sanitation. However, a recently challenge in many developed countries is the increase in domestic cases of invasive amebiasis as a sexually transmitted infection (STI amebiasis). In contrast to food-/ waterborne transmission of E. histolytica in developing countries, transmission of STI amebiasis occurs directly through human-to-human sexual contact (e.g., men who have sex with men and people who engage in oral-anal sex); in this setting, asymptomatic infected individuals are the main reservoir of E. histolytica. The Development of screening methods for the early diagnosis of asymptomatic E. histolytica infection is the key to epidemiologic control. Moreover, delay in diagnosis of severe cases (e.g., fulminant amebiasis) leads to death even in developed countries. It is also important to increase clinical awareness of domestically transmitted STI amebiasis in the clinical settings. This review considers the changing epidemiology and clinical manifestations of STI amebiasis, and finally discusses the future strategies for the better practice.
摘要:
Amebiasis,这是由溶组织内阿米巴(E.组织溶解),是全球寄生虫相关死亡的第二大原因。它表现为从无症状携带者到严重的临床状况,比如结肠炎和肝脓肿.阿米巴病在发展中国家很常见,由于卫生条件差,水和食物很容易被粪便污染。然而,许多发达国家最近面临的一个挑战是国内作为性传播感染的侵袭性阿米巴病(STIamebiasis)病例的增加.与发展中国家的溶组织大肠杆菌的食源性/水源性传播相反,性传播感染阿米巴病直接通过人与人的性接触发生(例如,与男人发生性关系的男人和从事口交的人);在这种情况下,无症状感染者是溶组织大肠杆菌的主要宿主。开发无症状的溶组织大肠杆菌感染的早期诊断筛查方法是流行病学控制的关键。此外,严重病例的诊断延迟(例如,暴发性阿米巴病)甚至在发达国家也会导致死亡。在临床环境中提高对国内传播的STI阿米巴病的临床认识也很重要。这篇综述考虑了性传播感染阿米巴病的流行病学和临床表现的变化,最后讨论了未来更好的实践策略。