Entamoeba histolytica: anyone had this parasite?
Wow, that was an expensive drip..... Charging 150 USD admission costs for a drip is a real rip off. Next time go to Central or Khema. They will charge about 30-50 for a 24H admission.....
To give you an idea about other pricing: Around 2 months ago, I did go with Grandma to Calmette for bad and very painful knees. It took 6 hours, all on 1 day, with 3 doctor consults, 2 X-Rays, 2 CT scans and 2 US scans, I did have to fork out USD 30.00 (cash prepayment). Oh, and Grandma is again walking around without pain. The meds did (and do) cost a fortune, though (around USD 160 a month).
Calmette is like a casino. A relatively cheap casino.v12 wrote:To give you an idea about other pricing: Around 2 months ago, I did go with Grandma to Calmette for bad and very painful knees. It took 6 hours, all on 1 day, with 3 doctor consults, 2 X-Rays, 2 CT scans and 2 US scans, I did have to fork out USD 30.00 (cash prepayment). Oh, and Grandma is again walking around without pain. The meds did (and do) cost a fortune, though (around USD 160 a month).
My wife went there in Nov 2017 and the blood results they presented were contradicted by Paramed, Khema (both in Phnom Penh) and a laboratory in Bangkok - so be careful!
Never again for me. At least not when it's about something more serious than a painful knee.
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Thanks for that. I would definitely go for Tinidazole over Metronidazole as a mono treatment option, and if I could acquire a combined Tinidazole/Paromomycin or Diloxanide Furoate combination therapy here, I'd go with that one over the protocol I'm following. Metronidazole certainly has been proven to wreak particular havoc on the microbiome, but not as much as other abx, like ciprofloxacin for example.Mèo Đen wrote:Treatment for Amebiasis, Intestinal - Tinidazole 2 g/day PO for 3 days, Amebic Liver Abscess 2 g/day PO for 3-5 days.
Also used for Giardiasis, then dosage is 2 g PO once.
Tablets are 500g and come in strips of 10 and cost somewhere between 2000 and 4000 Riel a strip.
Stopped using Metronidazole for treatment over 20 years ago because of side effects, efficacy etc.
Heres a relevant paper:
Tinidazole and metronidazole in the treatment of intestinal amoebiasis. Swami B, Lavakusulu D, Devi CS.Curr Med Res Opin. 1977;5(2):152-6.
Treatment had to be extended beyond 3 day in 53% of patients (8/15) on metronidazole as opposed to 11% (3/28) on tinidazole (p less than 0.01). The total number of side-effects, their severity, and the types were more in the metronidazole group. No toxic effects due to either drug were recorded. Tinidazole provided significantly higher cure rates than metronidazole in the treatment of symptomatic intestinal amoebiasis (p less than 0.01), and was better tolerated than metronidazole.
https://www.ncbi.nlm.nih.gov/pubmed/340131
Edit Here's a good paper on diagnosis -Laboratory Diagnosis of Amebiasis, Mehmet Tanyuksel, and William A. Petri Jr. CLINICAL MICROBIOLOGY REVIEWS, Oct. 2003, p. 713–729
https://www.ncbi.nlm.nih.gov/pmc/articl ... f/0073.pdf
The Metronidazole/Diloxanide Furoate combination has proven highly efficacious, though, so I'm prepared to stick it out:
https://www.ncbi.nlm.nih.gov/pubmed/9178149
http://annalskemu.org/journal/index.php ... /view/1796
If I had access to a compounding pharmacy here, I'd take a Secnidazole/Paromomycin combination, but I think we all know that's not happening
I know, right. Absolutely ridiculous. Although, I have received confirmation from my insurance that it's thankfully all covered, so it's a good result that readers of the forum know what they'd be coughing up for a trip to Raffles with minimal cost to myself (excluding insurance excess). I certainly wouldn't be taking myself there if I were here permanently.Kachang wrote:Wow, that was an expensive drip..... Charging 150 USD admission costs for a drip is a real rip off. Next time go to Central or Khema. They will charge about 30-50 for a 24H admission.....
Stories I've heard about Calmette over the years have scared the shit out of me - but I've also read it's improved.v12 wrote:To give you an idea about other pricing: Around 2 months ago, I did go with Grandma to Calmette for bad and very painful knees. It took 6 hours, all on 1 day, with 3 doctor consults, 2 X-Rays, 2 CT scans and 2 US scans, I did have to fork out USD 30.00 (cash prepayment). Oh, and Grandma is again walking around without pain. The meds did (and do) cost a fortune, though (around USD 160 a month).
In any case, apart from general malaise and a unfulfillable desire to drink booze, I'm feeling quite a bit better 24-hours into the treatment.
It's an absolute travesty when one can't have a beer in Cambodia, though
Kachang wrote:Calmette is like a casino. A relatively cheap casino.
My wife went there in Nov 2017 and the blood results they presented were contradicted by Paramed, Khema (both in Phnom Penh) and a laboratory in Bangkok - so be careful!
Never again for me. At least not when it's about something more serious than a painful knee.
I did leave the doctor/hospital choice to the family. Upfront, Calmette would not have been my first choice.Kim Jong Un wrote:Stories I've heard about Calmette over the years have scared the shit out of me - but I've also read it's improved.
In any case, apart from general malaise and a unfulfillable desire to drink booze, I'm feeling quite a bit better 24-hours into the treatment.
It's an absolute travesty when one can't have a beer in Cambodia, though
Though, looking at the result vs. spending, I am far from disappointed. I think, many EU doctors/hospitals would not have done (much) better, though would have been magnitudes more expensive and it would have been a 3 months task. Not so at Calmette. Of course, this kind of knee problems are pretty standard, though it is still a matter of choosing the right options. Doctors can screw up quite a lot on this and she didn't.
Would I go there myself for a cardiac arrest ? Given I probably won't have much opportunity to choose myself, the family might hand me in there to, with or without my consent
For the kind of problems of KJU, I may have gone to Dr. Scott myself. Then Paramed would have been involved to.
OP better stay away from alcohol for a few more days. The half life of Metronidazole is 24 hours if I remember well, so even after your last tablet it will remain in your blood for a few more days.
500mg per tab of metro ( Dilazol ) is too small a dosage for everyone. 800mg does the job 100%. It makes a few people feel sick.Kim Jong Un wrote:So, I found myself pretty fucking ill over the past couple of days and wound up at Raffles (formerly International SOS) yesterday. After the typical Asian-drip and leg-raising treatment, they took bloods and a stool sample. As it turns out, I have Entamoeba histolytica. I was happy with the service at Raffles and was prescribed a combination Metronidiazole/Diloxanide Furoate antibiotic, an antiemetic, and various rehydration supplements.
From my reading, it seems this is the standard protocol for this bug, so I'm glad Raffles is up to western standard diagnosis and treatment. This is a particularly nasty amoeba which can travel from the bowel to other vital organs, leading to some 50000 deaths around the world annually. I'm not too concerned about dying, but I'm curious as to whether anyone else has contracted this bug and how they treated it? Anyone taken Metronidiazole/Diloxanide Furoate combination (Dilozol) for this little bastard? How'd it go for you? I'm feeling like shit from it, so I'm guessing that's why the antiemetic is prescribed along with it.
Guess I'd better stop rimming bar-girls, eh? lol. Just kidding.
Any info/comments appreciated.
Much better is tinidazole. Dosage: 4x 500 mg tablets one time a day, once only. When I get amoeba h, , I take the 2000 mg dose an hour before sleep and feel no adverse effect like I do with metro.
If you have had the amoeba for 3 months or more, you need to follow the same treatment for three days (2000 mg @ one time for 3 days) in case it has entered the liver.
If you find the symptoms reoccurring 3 weeks after taking the tinidazole, you are being reinfected (very common )
A lot of people never get it, but If you're prone to it, there's a lot of it about. Mainly caught through unsanitary practices at food and beverage suppliers.(restaurants)
As for Diloxanide Furoate, I've never been able to source a supply here apart from what's in the Dilozol. The Tinidazole kills the amoeba in the intestines, and the Diloxanide Furoate kills the eggs in the colon.
Dilozol is expensive French medicine (made here) and the poor never buy it. Therefore,, the eggs keep infecting the water/ food.
Btw, tinidazole costs from 500 - 1000 riel per 500 mg tablet, so 50c - a dollar a dose.
Good advice. The only way to really tell is to put your blood into a very very expensive machine; like they have access to at hospitals in the West.Kachang wrote:You might want to skip that one. Stool tests for parasites are pretty unreliable and false negatives are common. The fact there's no parasites in the sample is no proof there's no parasites at all.Kim Jong Un wrote:I only went to Raffles as I'd been to International SOS in Saigon around five years ago and found them pretty decent by western standards. Raffles here was not quite as high a standard, and being election day there was only a Khmer doctor on. This is not a negative comment, though, he did a thorough job but his English wasn't the greatest.Fa Canal wrote:give us a breakdown of what it has cost you so far
Costs so far:
Treatment/pathology: $450 (after hour rate due to the election)
Meds: Around $12.
I have to go back for another stool test in a week to make sure I've cleared it, so I'm guessing there will be more pathology costs. I've never had this particular parasite before, so insurance should cover it.
And 450$ for a drip, consultation and stool test sounds extremely steep..... Even on election day.
Amoebic dysentery is way overdiagnosed world wide. It is next to impossible to diagnose from a stool sample not only because there will be occasional false negatives (cases where it may be present but not seen) but there are many more false positives (reported positive but actually negative). The reason for false positives is that there are amoebae in stool specimens which are morphologically similar or even indistinguishable from E. hystolytica but which are not pathogens. I think most western countries rely on PCR or other methods to make the correct diagnosis. You can read a bit from CDC about lab diagnosis of E. histolytica here : https://www.cdc.gov/dpdx/amebiasis/index.html
I'm always very sceptical when someone in Cambodia says they've been diagnosed with E. histolytica.
I'm always very sceptical when someone in Cambodia says they've been diagnosed with E. histolytica.
You can get a poop test for 30$ if you have it the treatment costs about same, cheaper if you choose not a fancy pharmaceutical brand.
Metronidazole 750mg and diloxanide fluorate 400mg 3 times a day for 10 or better 12 days.
The first kills the amoebae the second kills the cysts which can make it return some days later if not killed as they are much more resilient.
Be careful because clueless cambodian doctors give only 500mg metronidazole even to big dudes which isn't enough.
Metronidazole 750mg and diloxanide fluorate 400mg 3 times a day for 10 or better 12 days.
The first kills the amoebae the second kills the cysts which can make it return some days later if not killed as they are much more resilient.
Be careful because clueless cambodian doctors give only 500mg metronidazole even to big dudes which isn't enough.
missus has the full set and told me the prices,
Optional gastro protector 5$ dollars for the full treatment
Metronidazole 750mg and diloxanide are about 8$ for the full treatment.
So 13$ or so for the full set more or less.
Optional gastro protector 5$ dollars for the full treatment
Metronidazole 750mg and diloxanide are about 8$ for the full treatment.
So 13$ or so for the full set more or less.
as i suspected the last bout wasnt completely taken down by the metronidazole thats why it lasted so long after the mediation was taken and still left noticeable marks of an ominous natureFa Canal wrote:have taken Metronidiazole by itself on a number of occassions for some types of parasite that seems to hit my liver and swell into a largish lump under the skin in the left hip region, no, the medication doesnt affect me badly, neither does the parasite just crap being exuded from the site for weeks after taking the meds, so it must be that other stuff you are on causing the issues
havent identified the source of the parasite but got a few possible candidates. fairly certain they are food bourne in eggs stage. so anyone can point some light on that please do. these issues occur only when i have been in south east thailand/cambodia region for the months preceding the out break
any how been hit again by something under the arm this time, tinidazole has taken it down and also removed the ominous marks from the previous hit in the back left hip region, this is becoming a worry as havent had these hits so frequently in the past was years between before, perhaps it was just the previous hit after not being taken down properly relocating to the lung region, anyhow hope i have it down now before it hits the brain
had to ask about 6 pharma places before i could source the tinidazole not as avilable as the metrozinadole which most were offering me as a substitute
also suspect its was why all the dogs keep singling me out to bark at and harass, but since i have taken the recent bout down some dogs walking with the monks on their rounds saw fit to cross the busy street and have a go at me, we shall see
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.
could also has been the 400mg tablets of metronidazole which i was taking twice a day. perhaps three times a day for a total 1200g would have been more appropriate or even 4 times for 1600mg/day. all pharma i asked have only the 400mg tabs which i guess are suitable for the lighter weight thais
none of this medication has given me even the slightest side affects which also had me suspecting it was fake meds which has been common in thailand for all the years i have been there, fake meds not so common in cambo and laos in my experience at least
none of this medication has given me even the slightest side affects which also had me suspecting it was fake meds which has been common in thailand for all the years i have been there, fake meds not so common in cambo and laos in my experience at least
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.
actually in modern day thailand i wouldnt be surprised if these monks havent trained those dogs to attack foreigners, seems about how religious freaks conduct their business these days. the monks didnt offer any reproach when the dogs were coming barking across the road nor when the dogs had me bailed in a corner, it was only when the monks went on further that the dogs called it quits. big dogs well able to cause damage
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.