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Suggest Treatment For Entamoeba Histolytica Infection

Posted on Thu, 19 Feb 2015

Question: My wife initially had CYST reported as E.H. SEEN in last two reports, she was put on Metrogyl and then tinidazole for those cyst. Now in latest report cyst is not there but OVA - Round Worm seen has been reported.

She has been having itching from past 6 months and last doctor visit pointed to stool infection.

Please let us know which medicine to use to treat OVA - Round Worm

Answered by Dr. Sheetal Verma (4 hours later)

Brief Answer:
Antihelminthic drugs: Mebendazole or albendazole

Detailed Answer:
Thanks for your query at HCM!
I am Infectious Disease Specialist, Dr. Sheetal Verma answering your query!
I went through your query!

1. I understand that your wife was having Entamoeba histolytica infection and she took metronidazole and tinidazole for treatment and follow-up reports show no cysts. That's good she is cured and no need to bother about this infection further. Was there any ultrasound done to evaluate liver?

2. Now her latest reports are showing roundworm which is an Ascaris lumbricoides a nematode (roundworm) parasitizing the human intestine infection.

3. In this infection albendazole or mebendazole, are the treatment of choice to cure infection which are Anthelminthic medications (drugs that rid the body of parasitic worms). Mebendazole 100mg twice daily for 3 consecutive days or albendazole 400mg single dose. The drugs are effective and appear to have few side effects. Caution to be taken in pregnant and lactating mothers. These are prescribed medication.

4. After treatment again get your stool tested for routine microscopy for evaluation.

5. You can repeat the treatment again after 1 month.

6. It is usually found in association with poor personal hygiene and poor sanitary conditions. So it is advised to maintain good hygiene.Wash your hands with soap and warm water.Wash and cook all raw vegetables and fruits before eating.

Happy to take more queries! You can also write a review for me. If you would like some more information, I will be happy to provide. You can take a follow-up query.
Take care!
Dr. Sheetal Verma
Infectious Disease Specialist

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Sheetal Verma (17 minutes later)

Thanks Dr. XXXXXXX for the response. Only concern is point on personal hygiene and sanitary condition.

We normally take extra precaution for hygiene and sanitray condition. Although water in our society is very hard we use RO for drinking and cooking. Normally we wash fruits and vegetables with tap water and then with RO Water.

for sanitary condition we have explicitly installed XXXXXXX toilet and wash hands everytime we visit washroom.

I am little troubled by the fact that after so much precaution my wife was initially having cyst in stool and now ova.

What else we can do to take care of this problem, not sure if this stool infection is the root cause of her itching on and near her anus, till now no conclusive diagnosis has been done for her itching.

Please help in this issue

Answered by Dr. Sheetal Verma (12 minutes later)

Brief Answer:
Avoid eating foods from restaurants

Detailed Answer:
Happy to take your query.
It is very good that you maintain hygiene.
But sometimes in people with your cases they can get such infections from eating food at places like restaurants or roadside stalls. Try to avoid that also as it could be the cause.
Avoid eating salads at restaurants.
Wash the vegetables and fruits thoroughly.
As far as itching is concerned yes it happens in ascaris infections.Take antihistamines like cetrizine once a day.
Also get Hb, TLC and X Ray done as sometimes ascaris infection disseminates.
Take multivitamins and calcium supplements daily.
Don't worry take treatment you would be fine.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Sheetal Verma (26 hours later)

In case person has both CYST and OVA then in stool report we should see both right? please confirm? Or one can surpress other in detection in stool test

Reason i am asking this question is, last month stool test only shower CYST and latest one shows No Cyst but only OVA.

Also, since her itching has been there for almost 8 months now, I am worried that if OVA and CYST infer in each other diagnosis then we might have bigger problems.

Please confirm if these two interfere in each other diagnosis or they are independent?

Answered by Dr. Sheetal Verma (39 minutes later)

Brief Answer:
No interference 100% sure. Do not worry.

Detailed Answer:
Hi,

I understand your concern.

There is no interference of either infection with each other.
But both if co exist they individually affect the patients health.
Be sure of the reliability of laboratory you got your test done.
As your stool shows no Entamoeba cyst you need not worry.
Ascarisis infection might have been missed in earlier reports due to intermittent shedding of ova.
Yes, sometimes urticaria exist in such patients for prolonged time which causes itching.
You take treatment and post that get the stool microscopy repeated.

I hope treatment will relieve your itching.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Ashwin Bhandari