Entamoeba histolytica: anyone had this parasite?
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Entamoeba histolytica: anyone had this parasite?
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.
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.
give us a breakdown of what it has cost you so far
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.
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
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
Last edited by Fa Canal on Mon Jul 30, 2018 10:17 am, edited 1 time in total.
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.
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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.
This parasite is so common / endemic Cambodia I think we've contacted it all, although maybe some of us don't know. Sometimes the body keeps it under control and you have a mild infection.
It gives you the runs, sometimes a bad one, but the main risk is the parasite moving to the liver creating an amebic liver abscess which has to be drained, or even worse, move to the brain an create an abscess there which can not be drained. I guess from your symptoms they could tell this is not the case with you, otherwise they would have made an echo of your liver.
Better finish you Metronidazole and if you have an allergy or respond badly you can change to Tinidazole.
It gives you the runs, sometimes a bad one, but the main risk is the parasite moving to the liver creating an amebic liver abscess which has to be drained, or even worse, move to the brain an create an abscess there which can not be drained. I guess from your symptoms they could tell this is not the case with you, otherwise they would have made an echo of your liver.
Better finish you Metronidazole and if you have an allergy or respond badly you can change to Tinidazole.
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.
ciproflux, metro, doxy, omeprazole or another one beginning with T, tindazole, or something seem to work when I get sth bad.
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Well now I'm wishing I'd gone for a diagnosis when I was unwell for a couple of weeks - not that I'd have been likely to pay that much. What would the cost be when not a holiday? Maybe $180?
And are the signs distinguishable from food poisoning/gastro?
Edit. I could Google.
And are the signs distinguishable from food poisoning/gastro?
Edit. I could Google.
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Not really, but when you have Amebiasis in general you have a very slimy and sometimes bloody stool. Not just the runs which you often have when suffering from a bacterial infection.violet wrote:Well now I'm wishing I'd gone for a diagnosis when I was unwell for a couple of weeks - not that I'd have been likely to pay that much. What would the cost be when not a holiday? Maybe $180?
And are the signs distinguishable from food poisoning/gastro?
Edit. I could Google.
Cipro and similar won't help against Amoeba.
I contracted it while working in the Philippines in 2000. Rather stupidly, I didn't seek treatment for more than a month, losing about 15kg. and becoming skeletal and listless. The publishing company I worked for sent me to a clinic, where it was diagnosed through a stool test. I was prescribed the same combination of antibiotics you described and the symptoms cleared in a week, with no after effects. You seem to have made the right choice for treatment.
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Agreed. It's an absurd amount of money, but the main reason I went there is I figured it would be the most likely place in Phnom Penh to use PCR (Polymerase chain reaction) diagnostics, which are far more accurate as they test for parasite DNA rather than just slide microscopy.Kachang wrote:You might want to skip that one. Stool tests for parasites are pretty unreliable and false negatives are common. The fact there's no parasites in the sample is no proof there's no parasites at all.
And 450$ for a drip, consultation and stool test sounds extremely steep..... Even on election day.
Insurance should cover it anyway.
Ciprofloxacin is a horrible antibiotic that has caused a number of serious issues in many people. For example, it's no longer recommended for use in Australia at all. The ~azole derivatives are all effective, but antibiotic resistance is rising all the time. The best one for parasitic/amoeba infections is Secnidazole, but it's not available here. I'll definitely be switching to Tinidazole if I continue feeling like rubbish.pedros wrote:ciproflux, metro, doxy, omeprazole or another one beginning with T, tindazole, or something seem to work when I get sth bad.
Symptoms are pretty similar, Violet, with possible accompanying left flank/hip pain (like Pedros said), feeling woozy and numbness. I'd try find out for certain if anywhere does PCR testing here and get yourself checked out. I contracted Dientamoeba fragilis six years ago and it took two years, a good gastroenterologist and PCR to find it; then combination Secnidazole/Doxycycline to get rid of it. Absolutely ghastly experience.violet wrote:Well now I'm wishing I'd gone for a diagnosis when I was unwell for a couple of weeks - not that I'd have been likely to pay that much. What would the cost be when not a holiday? Maybe $180?
And are the signs distinguishable from food poisoning/gastro?
Edit. I could Google.
I have no idea what the regular cost of Raffles would be.
Parasites are fucking horrible. Some people can be totally incapacitated while others are asymptomatic. I seem to be of the first category, unfortunately.
Yeah, I'm certainly hoping soGilmore wrote:I contracted it while working in the Philippines in 2000. Rather stupidly, I didn't seek treatment for more than a month, losing about 15kg. and becoming skeletal and listless. The publishing company I worked for sent me to a clinic, where it was diagnosed through a stool test. I was prescribed the same combination of antibiotics you described and the symptoms cleared in a week, with no after effects. You seem to have made the right choice for treatment.
On another note, which hospital is currently most recommended here? I've lurked this forum for a while and I've gathered some have improved over the years, but my memory fails me at the moment.
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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
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
Last edited by Mèo Đen on Mon Jul 30, 2018 1:18 pm, edited 1 time in total.
^^thanks for that^^
WARNING: this post is not intended for the mentally impaired perhaps search for the chicken's post and read them instead. thanks.