Difficulties in the Treatment of Intestinal Amoebiasis in Mentally Disabled Individuals at a Rehabilitation Institution for the Intellectually Impaired in Japan

Background: A mass Entamoeba histolytica infection recurred despite repeated treatments with metronidazole at a rehabilitation institution for individuals with intellectual impairments. Methods: Diloxanide furoate was administered to improve intractable intestinal amoebiasis after a recurring amoebic infection that tends to occur via coprophagy in mentally disabled individuals infected with E. histolytica at an institution (the prevalence rate and positive serology rate were 38.2 and 67.1%, respectively). The therapeutic effect of the drugs was judged by microscopic stool examination and an E. histolytica antigen detection kit. Results: The mass infection was eliminated through the administration of metronidazole and subsequent use of diloxanide furoate. Conclusions: Combination therapy successfully cured and prevented transmission of the mass E. histolytica infection at the institution.

[1]  Apolinaria García,et al.  In vitro Antagonism of Rabeprazole and Metronidazole upon Clinical Isolates of Helicobacter pylori , 2009, Chemotherapy.

[2]  J. Samuelson,et al.  Giardia, Entamoeba, and Trichomonas Enzymes Activate Metronidazole (Nitroreductases) and Inactivate Metronidazole (Nitroimidazole Reductases) , 2008, Antimicrobial Agents and Chemotherapy.

[3]  F. Chan,et al.  Levofloxacin-Resistant Helicobacter pylori in Hong Kong , 2007, Chemotherapy.

[4]  T. Nozaki,et al.  Diversity of clinical isolates of Entamoeba histolytica in Japan. , 2006, Archives of medical research.

[5]  T. Nozaki,et al.  Geographic Diversity among Genotypes of Entamoeba histolytica Field Isolates , 2003, Journal of Clinical Microbiology.

[6]  E. Tannich,et al.  Treatment of asymptomatic intestinal Entamoeba histolytica infection. , 2002, The New England journal of medicine.

[7]  J. Roberts,et al.  Diloxanide furoate for treating asymptomatic Entamoeba histolytica cyst passers: 14 years' experience in the United States. , 1992, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  S. Kobayashi,et al.  Distinguishing pathogenic isolates of Entamoeba histolytica by polymerase chain reaction. , 1991, The Journal of infectious diseases.

[9]  T. Nozaki,et al.  Application of a micro enzyme-linked immunosorbent assay (ELISA) to detection of anti-amebic antibody in various forms of amebic infection. , 1988, The Japanese journal of experimental medicine.

[10]  P. Sargeaunt Zymodemes of Entamoeba histolytica. , 1987, Parasitology today.

[11]  G. Robinson The laboratory diagnosis of human parasitic amoebae. , 1968, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[12]  L. S. Ritchie An ether sedimentation technique for routine stool examinations. , 1948, Bulletin of the U.S. Army Medical Department. United States. Army. Medical Department.

[13]  Ritchie Ls ETHER sedimentation technique for routine stool examinations. , 1948, Circular letter. United States. Far East Command. Medical Section.