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Information

Microscopic examination of three stool samples, often combined with serologic testing, remains the standard diagnostic approach.

Treatment: Amebiasis

  • Tinidazole (2 g/d PO for 3 days) or metronidazole (750 mg PO or IV tid for 5-10 days) is recommended for amebic colitis and amebic liver abscess.
    • - Within 3 days of treatment initiation, >90% of pts respond clinically.
    • - Drainage of liver abscesses is rarely needed. Indications for aspiration include the need to rule out pyogenic abscess, a lack of response to treatment in 3-5 days, an imminent threat of liver-abscess rupture, or the need to prevent left-lobe abscess rupture into the pericardium.
  • Pts with either colitis or liver abscesses should also receive a luminal agent to ensure eradication of the infection. Paromomycin (500 mg PO tid for 10 days) is the preferred agent; iodoquinol (650 mg PO tid for 20 days) is an alternative.

Outline

Section 7. Infectious Diseases