Hemolytic uremic syndrome associated withEntamoeba histolytica intestinal infection

Abstract

Amebiasis secondary to Entamoeba histolytica (E. histolytica) continues to be a major source of morbidity and mortality worldwide, mainly in developing countries. An association between amebic dysentery and hemolytic uremic syndrome (HUS) has been mentioned, but a cause-and-effect relationship has never been confirmed. We report the case of an 11-year-old healthy white female who developed severe bloody diarrhea after drinking contaminated unboiled water, developing classic HUS and requiring acute intermittent hemodialysis. The etiological study confirmed numerous cysts and hematophagous trophozoites of E. histolytica on stool smear, but without evidence of other pathogens. This report contributes to the concept that classic post-diarrheal HUS, usually related to colitis secondary to enterohemorragic Shiga-toxin producing Escherichia coli (E.coli) strains, may be associated with other pathogens, including E. histolytica. Additional information regarding mechanisms of virulence of E. histolytica and host immunological reaction is needed to clarify the temporal association of these two disorders (HUS and amebiasis).

Acute renal failure following Entamoeba histolytica treatment in a 9-year-old girl

“…[2] Entamoeba histolytica has also been known as an etiologic factor for HUS in developing countries. [2][3][4] There is not precise pathological definition between Entamoeba and renal disease at the moment, [5][6][7] some theories explained appearance of holes called amoebapore which were made by adhering of some molecules to lecithin cell walls and killing cell or by similar mechanism like as Shiga toxin, which in amebiasis it will be done by cystine protease enzyme that ultimately increase production of tumor necrosis factor-α by macrophage and leading to cell death [8][9][10][11] and some virulent forms may exhibit their cytotoxic effects by involving in immune system. [12] Our case was a 9-year-old girl affected to HUS during an epidemic amebiasis.…”

The Context of Ethical Problems in Medical Volunteer Work

“…Overcrowding encourages the spread of respiratory infections such as tuberculosis and pneumonia (Isturiz and Carbon 2000;Keshavjee et al 2008). Contaminated water increases the risk of acquiring many infections, including cholera and amebiasis (Cavagnaro et al 2006;Chaignat et al 2008). Even when patients are successfully treated for these infections, the likelihood of recurrence is high because the source of disease has not been eliminated.…”

Ethics for international medicine: a practical guide for aid workers in developing countries

“…For example, overcrowding encourages the spread of respiratory infections such as tuberculosis and pneumonia (Isturiz and Carbon 2000). Similarly, contaminated water increases the risk of acquiring many infections, including cholera and amebiasis (Cavagnaro, Guzman, and Harris 2006;Chaignat et al 2008). Poverty and poor living conditions significantly limit the ability of medical aid workers to care for patients.…”