Department of Parasitology, Yonsei University Medical College, Seoul, Korea.
Director of Institute of Tropical Medicine, Yonsei University, Seoul, Korea.
Abstract
This review dealt with biology, host-parasite relationship, symptomatology, epidemiology, diagnosis, treatment of Entamoeba histolytica infection and free livng amoeba.
Figures
Fig. 1 E. histolytica trophozoites. Showing the nuclear structures in photo and the diagram.
Fig. 2 E. histolytica trophozoites. Showing the nuclear structures in photo and the diagram.
Fig. 3 E. histolytica cysts. Showing the distinct two nuclei in photo and four nuclei in the diagram.
Fig. 4 E. histolytica cysts. Showing the distinct two nuclei in photo and four nuclei in the diagram.
Fig. 5 Scanning electron micrograph of E. histolytica cyst.
Figs. 7-9 Fig. 7. Normal E. histolytica. Showing acid phosphatase activity. The reaction is observed in the botton bodies (arrow) and vacuoles. (×9,900)
Fig. 8, 9. Same features as above in control. (×10,500 and ×13,200)
Figs. 10-11 Fig. 10. Beginnig stage of immobilization 30 minutes after reaction with patient's serum. (×9,000)
Fig. 11. Immobilized E. histolytica. Helical aggregates (HA) are shown. (×21,000)
Fig. 12 Phopagation curves (mean) of cyst originated. E. histolytica strains at various temperature conditions.
Fig. 13 Phopagation curves (mean) of E. histolytica strains YS-23, YS-24, YS-27 and NAMRU-II at various temperature conditions.
Fig. 14 Comparison of percentaage of blood eosinophils in each experimental group.
Figs. 17-18 Chronic amebic ulcer of the colon involving submucosa (Fig. 17). Showing solitary ameba (arrow) and high power view (Fig. 18). (H-E, ×100, ×450)4
Figs. 19-20 Amebic liver abscess. Invaded ameba (arrow) in the parenchyma of the liver (Fig. 19) and the high power view (Fig. 20). (H-E, ×100, ×450)
Fig. 21 Possible processes of amebic liver abscess formation.
Fig. 22 Prevalences of Entamoeba histolytica infection in Korea. (Kim et al.,, 1971)
Figs. 23-25 Fig. 23, 24. Negative(lift) and positive(right) reactions of indirect fluorescent antilbody(IFA) test for diagnosis of amebiasis.
Fig. 25. Liver scan. Showing the cold area(arrow) in right upper portion.
Fig. 26-29 Fig. 26, 27. Ultrasonogram of amebic liver abscess. Showing cold areas before (Fig. 26) and after treatment.(Fig. 27).
Fig. 28, 29. Ameba immobilization test. Normal (Fig.28) and immobilized trophozoites. (Fig. 29).
Fig. 30 Chemical structures of niridazole and metronidazole.
Fig. 31 Chemical structures of Tinidazole(Fasigyn)
Fig. 33 Scanning electron micrographs of free-living amebae.
1. Acanthamoeba royreba trophzoite.
2. Acanthamoeba sp., YM-4 trophzoite.
3. Acanthamoeba lenticulata trophzoite.
4. Naegleria fowleri trophzoite.
Figs. 34-37 Fig. 34. Brain of mouse infected with Acanthamoeba sp. (YM-2). Showing extensively edematous and hemorrhagic changes(B) comparing with the mormal(A).
Fig. 35, 36. Trophzoite and cyst of Acanthamoeba sp. (YM-2).
Fig. 37. Mouse brain infected with Acanthamoeba sp. (YM-2). Acute inflammatory change and the amebae (arrow) are shown.
Fig. 38 Agglutination of Acanthamoeba sp. (YM-4) before (A) and 45 minutes (B) after treatment with concanavalin A
Fig. 39 Electron microscopic findings in the control group.
1. A. royreba; Irregular cell membrane(CM), vacuoles(V) of different size, mitochondria(M), lipid droplet(L), rought endoplasmic reticulum(rER) and ribosomes(R) are observed.
2. Acanthamoeba sp. YM-4; Cell membrane, vacuoles, mitochondria and lipid droplet are shown.
3. A. lenticulata; Rough endoplasmic reticulum, mitochondria and vacuoles are demonstrated.
4. N fowleri; Many small vacuoles and nucleus with nucleolus are observed.
Fig. 40 Electron microscopic findings in the concanavalin A treated group.
1. A. royreba; No difference in the ultrastructure compared with the control.
2. Acanthamoeba sp. YM-4; Electron density along cell memnbrane increased slightly.
3. A. lenticulata; Electron density of cell memnbrane increased slightly, and lysosomes(LY) are observed.
4. N fowleri; No remarkable finding was shown compared with control.
Fig. 41 Electron microscopic findings in the horseradish peroxidase treated group.
1. A. royreba; Mitochondria were demonstrated remarkably.
2. Acanthamoeba sp. YM-4; Electron-dense reaction product was shown exclusively on the mitochondria and lysosome, and rough endoplasmic reticulum was observed.
3. A. lenticulata; Electron-dense mitochondria and lysosomes are shown.
4. N fowleri; Mitochondria and lipid droplet are shown.
Fig. 42 Electron microscopic findings in the group treated with concanawalin A and horseradish peroxidase.
1. A. royreba; There was no obvious difference with regard to the electron density of the cell membrane compared with control.
2. Acanthamoeba sp. YM-4; Electron-dense reaction product was demonstrated remarkably on the cell membrane, mitochondria and lysosome.
3. A. lenticulata; Electron-dense reaction product was observed exclusively on th cell membrane, mitochondria and lysosome.
4. N fowleri; Increased electron density on the form of intermittent aggregation.
Fig. 43 Cummulative death curve after intracranial infection of amebae in immunized mice.
△─△ : intraperitoneally immunized with 5×105 amebae once
▲…▲ : intraperitoneally immunized with 5×105 amebae twice.
□--□ : intraperitoneally immunized.
●…● : control.
Fig. 44 Cummulative death curve after intracranial infection of amebae in immunosuppressed mice.
△─△ : prednisolone treated.
□--□ : gamma-ray irradiated.
●…● : control.
Tables
Table 1 Classification of the order Amoebina (Kudo, 1954)
Table 2 Pathogenicity of Entamoeba histolytica. strains in Sprague-Dawley rat (Soh et al., 1969)
Table 3 Strains of Entamoeba histolytica. (Cho et al., 1972b)
Table 4 Growth of Entamoeba histolytica in modified diphasic medium to which rabbit red blood cells were added (Ro, 1967)
Table 5 Growth of Entamoeba histolytica in modified diphasic medium to which sheep red blood cells were added (Ro, 1967)
Table 6 Comparison of numbers of the mesenteric mast cells, and of degree of disrupted or degranulated mesenteric mast cells in mice ingected with Entamoeba histolytica, strain YS-24 (Im et al., 1975)
Table 7 Development of amebic ulcers in rat intestine after treatment with hormones (Lee, 1968)
Table 8 Development of amebic ulcers in rat intestine after exposure to shaking stress (Lee, 1968)
Table 9 Size of amebic ulcers in rat intestine compressed with surgical forceps (Lee, 1968)
Table 10 Number of amebic ulcers after previous Shigella dysenteriae infection in rat (Lee, 1968)
Table 11 Incidence of bacillary and amebic dysentery (Chun, 1975)
Table 12 Subjective symptoms in 48 cases of amebic colitis (Byoun and Hong, 1968)
Table 13 Objective symptoms in 48 cases of amebic colitis (Byoun and Hong, 1963)
Table 14 Stool nature and frequency of defecation in 48 cases of amebic colitis (Byoun and Hong, 1963)
Table 15 Physico-pathological findings in 48 cases of amebic colitis (Byoun and Hong, 1963)
Table 16 Prevalence of hepatomegaly in Jeju-Do (Cho et al., 1967)
Table 17 Clinical category, age group and sex distribution of amebiasis in Che-ju Island (Hong et al., 1967)
Table 18 Bacteriological examination of liver abscess in Che-ju Island (Hong et al., 1968)
Table 19 Development of amebic liver abscess in various experimental animals (Im and Kim, 1976)
Table 20 The effect of thioacetamide upon the development of amebic liver abscess in rats (Im and Kim, 1976)
Table 21 The effect of carbon tetrachloride upon the development of amebic liver abscess in rats (Im and Kim, 1976)
Table 22 Protozoa found in human subjects in Korea (Soh, 1973)
Table 23 Prevalences of intestinal protozoa according to age and sex (Kim et al., 1971)
Table 24 Prevalences of of Entamoeba histolytica infection in Korea
Table 25 Prevalences of of Entamoeba histolytica infection by age and sex in Korea (Kim et al., 1971)
Table 26 Prevalences of of Entamoeba histolytica infection by age in Jeju-Do (Kim, 1967)
Table 27 Age and sex distribution of amebic dysentery cases in Busan Children's Charity Hospital (Yoon and Choi, 1966)
Table 28 Amebic dysentery cases according to occupation. From the records of the clinical laboratory of Severance Union Medical College, 1913~1917 (Mills, 1927)
Table 29 Monthly incidence of intestinal protozoa among the out-patients of Severance Hospital, July 1, 1959~June 30, 1961 (Soh et al., 1961)
Table 30 Monthly cases of amebic dysentery in 10 provincial hospitals in Korea (Sato, 1913)
Table 31 E. histolytica cysts in various samples from Jeju Do (Kim, 1967)
Table 32 Entamoeba histolytica infection by household in Jeju-Do (Cho et al., 1967)
Table 33 Direct versus MGL versus rolling method in the detection of intestinal protozoa (Cho et al., 1972 d)
Table 34 Reproducibility of serological tests for diagnosis of amebiasis
Table 35 Reactivity of indirect fluorescent antibody(IFA) and ameba immobilization(AI) tests on Entamoeba histolytica (YS-9) with the sera of amebiasis cases in Cheju-Island (Cho and Soh, 1969)
Table 36 Comparisons of indirect fluoresecent antibody(IFA) and ameba immobilization(AI) tests in sera of amebiasis cases in Cheju-Island (Cho and Soh, 1969)
Table 37 Distribution of antibody reactivity by immunological tests in Entamoeba histolytica infected cases (Min, 1975)
Table 38 Results of latex agglutination(LA) test on serum from 24 patients with extraintestinal amebiasis, 19 cases with intestinal amebiasis and 20 healthy controls (Cho, 1974)
Table 39 Comparison of latex agglutination(LA) test with the results indirect hemagglutination (IHA), indirect fluorescent antibody (IFA), and ameba immobilization(AI) tests for the diagnosis of E. histolytica infections (Cho, 1974)
Table 40 Results of gel-dissusion precipitation(GDP) test on surum from 22 patients with extraintestinal amebiasis, 22 case with intestinal amebiasis, 21 healthy controls and 74 patients with miscellaneous non-amebic diseases (Cho, 1974)
Table 41 Comparison of gel-dissusion precipitation(GDP) test with indirect hemagglutination(IHA), indirect fluorescent antibody (IFA), and ameba immobilization(AI) tests for the diagnosis of E. histolytica infections (Cho, 1974)
Table 42 Amebicidal activity of conventional antiamebic drugs in vitro (Cho et al., 1969)
Table 43 Amebicidal activity of antibiotics and newly appeared synthetics (Cho et al., 1969)
Table 44 Regimen of Fasigyn to various group of E. histolytica infection and amebicidal activity based on the rate of negative conversion after the treatment (Soh and Min, 1974)
Table 45 Results of double blind trial in cyst carriers by tiberal and metronidazole versus placebo (Cho et al., 1976)
Table 46 Treatment of hepatic amebiasis by intravenous administration of 2gm of Ornidazole in two doses (Soh et al., 1978)
Table 47 Treatment of hepatic amebiasis by administration of 2.5gm Ornidazole in single dose (Soh et al., 1978)
Table 48 Death rate of mice after challenge infection with Acanthamoeba sp. YM-4
Table 49 Death rate after intracranial infection of 1×104Acanthamoeba sp. (YM-4) in prednisolone and gamma-ray treated mice.
References
1.
Ahn M, et al. . Yonsei J Med Sci 1979;12(1):28–37.
2.
Ahmad I. Yonsei Rep Trop Med 1973;4:148.
3.
Biagi F, Buentello L. Immobilization reaction for the diagnosis of amebiasis. Exp Parasitol 1961;11:188–190.
4.
Boeck WC, et al. Am J Hyg 1925;5(4):371–407.
5.
Brooke MM, Swartzwelder C, Payne FJ, Weinstein P, Frye WW. Intestinal parasite survey of Korean prisoner-of-war camp. U S Armed Forces Med J 1956;7(5):708–714.
6.
Burrows RB, Swerdlow MA, Frost JK, Leeper CK. Pathology of Dientamoeba fragilis infections of the appendix. Am J Trop Med Hyg 1954;3(6):1033–1039.
7.
Byoun JS, et al. Korean New Med J 1968;19(9):53–57.
8.
Cabrera HA. Temperature adaptation of Entamoeba histolytica and its effect on virulence. Exp Parasitol 1958;7(3):276–284.
9.
Cabrera HA, Porter RJ. Survival time and critical temperatures of various strains of Entamoeba histolytica. Exp Parasitol 1958;7(3):285–291.
10.
Carrera GM, Changus GW. Demonstration of acid phosphatase in Endamoeba histolytica. Proc Soc Exp Biol Med 1948;68(3):610.
11.
Carrera GM. Arch Pathol 1950;50:440–449.
12.
Chang WI, et al. Kunjin Eui-Hak 1964;10:72.
13.
Chiba E, et al. Keijo J Med 1930;1(2):24–28.
14.
Chiba H. Chosen Igakkai Zassi 1931;21:508–552.
15.
Cho KM, et al. Korean New Med J 1967;7(5):605–612.
16.
Cho KM. J Korean Mod Med 1968;8:57–76.
17.
Cho KM, et al. Yonsei Med J 1969;10(2):173–179.
18.
Cho KM, Lee JY, Soh CT. Virulence Of Entamoeba Histolytica According To The Strains In Korea: III. Amebicial Response Of Antiamoebic Agents On Several Strains Of Entamoeba Histolytica In Vitro. Korean J Parasitol 1969;7(3):121–128.
19.
Cho KM, et al. Yonsei Rep Trop Med 1971;2(1):134–144.
20.
Cho KM, et al. Yonsei Rep Trop Med 1972;3(1):37–59.
21.
Cho KM, et al. Yonsei Rep Trop Med 1972;3(1):73–80.
22.
Cho KM, et al. Yonsei Rep Trop Med 1972;3(1):123–133.
23.
Cho KM, et al. Yonsei Rep Trop Med 1972;3(1):150–152.
24.
Cho KM, et al. Yonsei Rep Trop Med 1973;4(1):5–18.
25.
Cho KM, et al. Yonsei Rep Trop Med 1976;7(1):40–50.
26.
Choi D. Chosen Igakkai Zassi 1926;66:1–10.
27.
Choi DS. Korean J Internal Med 1968;11(7):47–50.
28.
Choi KC. Yonsei J Med Sci 1969;2(1):107–119.
29.
Chung KS, et al. Yonsei J Med Sci 1980;13(1):72–81.
30.
Chung PR, et al. Korean New Med J 1970;13:47–52.
31.
Chung PR, et al. Yonsei Rep Trop Med 1976;7(1):51–60.
32.
Cotter DA. Human meningoencephalitis caused by the free-living amoebae. Am J Med Technol 1973;39(10):417–420.
33.
Craig CF. Am J Trop Med 1927;7:225–240.
34.
Doshi JC, Doshi MJ, Vaidya AB, Mehta JM, Sheth UK. Niridazole in amebic dysentery and hepatic amebiasis. Am J Trop Med Hyg 1968;17(5):702–708.
35.
Eaton RD, Meerovitch E, Costerton JW. The functional morphology of pathogenicity in Entamoeba histolytica. Ann Trop Med Parasitol 1970;64(3):299–304.
36.
el-Hashimi W, Pittman F. Ultrastructure of Entamoeba histolytica trophozoites obtained from the colon and from in vitro cultures. Am J Trop Med Hyg 1970;19(2):215–226.
37.
Eranko O, et al. Acta Anat Suppl 1952;17:1–60.
38.
Fletcher KA, Maegraith BG, Jarumilinta R. Electron microscope studies of trophozoites of Entamoeba histolytica. Ann Trop Med Parasitol 1962;56:496–499.
39.
Gogler H, Knight R. The effect of hepatic injury upon the development of amoebic liver abscess in hamsters. Ann Trop Med Parasitol 1974;68(2):177–185.
40.
Goldman M. Evaluation of a fluorescent antibody test for amebiasis using two widely differing ameba strains as antigen. Am J Trop Med Hyg 1966;15(5):694–700.
41.
Hong SO, et al. Yonsei Med J 1968;9(2):127–138.
42.
Hwang HK, et al. Yonsei J Med Sci 1976;9(2):86–98.
43.
Hwang YN, et al. Yonsei Rep Trop Med 1980;12(1):1981.
44.
Im KI, Hwang HK, Soh CT. [Behaviour Of Mast Cells In Mice In The Course Of Entamoeba Histolytica Infection By Strains]. Korean J Parasitol 1975;13(2):115–122.
45.
Im KI, et al. Yonsei Rep Trop Med 1976;7(1):61–67.
46.
Im KI, Oh HS. [Immunological Tests By Anti-Free-Living Amoebas Serum Produced In Experimental Animals: I. Immobilization Of Free-Living Amoebas In Vitro By Rabbit Antiserum]. Korean J Parasitol 1978;16(1):41–46.
47.
Jhee HT. Korean Central Med J 1962;2(2):153–156.
48.
John DT, Weik RR, Adams AC. Immunization of mice against Naegleria fowleri infection. Infect Immun 1977;16(3):817–820.
49.
Jones WR. Ann Trop Med Parasit 1946;40:130–140.
50.
Kang WB, et al. Korean Central Med J 1967;13(3):231–283.
51.
Kasprzak W, Mazur T. [Free-living amoebae isolated from waters frequented by people in the vicinity of Poznań, Poland. Experimental studies in mice on the pathogenicity of the isolates]. Z Tropenmed Parasitol 1972;23(4):391–398.
52.
Kessel JF. China Med J 1925;33:975–982.
53.
Khambatta RB. Medicine Today 1969;3(1):72–74.
54.
Kim CH. Chosen Igakkai Zassi 1914;10:63–64.
55.
Kim CH, et al. Yonsei Rep Trop Med 1971;2(1):30–43.
56.
Kim CK, et al. Yonsei J Med Sci 1979;12(2):34–44.
57.
Kim CY. J Pediatrics 1971;14:372–382.
58.
Kim DJ, et al. Korean J Internal Med 1968;11(4):253–256.
59.
Kim JS. Korean Med J 1963;8(7):27.
60.
Kim MC. Chonnam Med J 1964;1(1):97–101.
61.
Kim NW, et al. Yonsei Rep Trop Med 1973;4:59–64.
62.
Kim OC. Korean Med J 1967;12(12):935–945.
63.
Kim ST. Korean Med J 1962;7(9):33–35.
64.
Kradolfer F, Jarumilinta R. Ciba 32,644-Ba, A New Systemically Active Amoebicide. Ann Trop Med Parasitol 1965;59:210–218.
65.
Krupp IM. Amebic invasion of the liver of guinea pigs infected with the larvae of a nematode, Toxocara canis. Exp Parasitol 1956;5(5):421–426.
66.
Krupp IM. Modification of the indirect haemagglutination test for amoebiasis. J Clin Pathol 1969;22(5):530–533.
67.
Krupp IM, Powell SJ. Antibody response to invasive amebiasis in Durban, South Africa. Am J Trop Med Hyg 1971;20(3):414–420.
68.
Kuwabara N. Chosen Igakkai Zassi 1930;20(3):261–300.
69.
Lah SS. Collected thesis from Catholic Med College 1960;4:263–268.
70.
Lee DH, et al. J Korean Med Assoc 1965;8(6):75–78.
71.
Lee BJ. Yonsei J Med Sci 1968;1(1):54–68.
72.
Lim YC, et al. Theses of Catholic Med College 1965;9:109–115.
73.
Love R, Studzinski GP, Walsh RJ. Nuclear, nucleolinar and cytoplasmic acidphosphatases in cultured mammalian cells. Exp Cell Res 1969;58(1):62–72.
74.
Ludlow AI. China Med J 1926;40:1166–1186.
75.
Maddison SE. Characterization Of Entamoeba Histolytica Antigen Antibody Reaction By Gel Diffusion. Exp Parasitol 1965;16:224–235.
76.
Maddison SE, Kagan IG, Elsdon-Dew R. Comparison of intradermal and serologic tests for the diagnosis of amebiasis. Am J Trop Med Hyg 1968;17(4):540–547.
77.
Mills RG. Am J Hyg 1927;7(3):222–263.
78.
Moon KS. . Kunjin Eui-Hak 1964;10(1):72.
79.
Morris MN, Powell SJ, Elsdon-Dew R. Latex agglutination test for invasive amoebiasis. Lancet 1970;1(7661):1362–1363.
80.
Nagahana K. Chosen Igakkai Zassi 1935;25:1421–1432.
81.
Neal RA. Some observations on the variation of virulence and response to chemotherapy of strains of Entamoeba histolytica in rats. Trans R Soc Trop Med Hyg 1951;44(4):439–452.
82.
Neal RA, Johnson P. The virulence to rats of five Entamoeba histolytica-like strains capable of growth at 25 degrees C and attempts to discover simular strains. Parasitology 1968;58(3):599–603.
83.
Park JY, et al. Korean Med J 1966;11(3):47–49.
84.
Pederson KO. Nature(London) 1944;154:575.
85.
Powell SJ, Wilmot AJ, Macleod I, Elsdon-Dew R. The effect of a nitro-thiazole derivative, Ciba 32,644-Ba, in amebic dysentery and amebic liver abscess. Am J Trop Med Hyg 1966;15(3):300–302.
86.
Powell SJ. Far East Med J 1969;5:322–324.
87.
Ringsted J, Jager BV, Suk D, Visvesvara GS. Probable acanthamoeba meningoencephalitis in a Korean child. Am J Clin Pathol 1976;66(4):723–730.
88.
Roh HJ, et al. J Korean Med Assoc 1948;1(1):29–30.
89.
Ro YJ. Korean New Med J 1967;10(12):101–111.
90.
Carrera GM, Sadun EH, Faust EC. The effect of protein deficient diets on the susceptibility of guinea pigs to infection with Endamoeba histolytica. Am J Trop Med Hyg 1952;1(6):966–969.
91.
Sato T. Chosen Igakkai Zassi 1913;8:11–86.
92.
Shaffer JG, Iralu V. The effect of erythrocytes on the propagation of Entamoeba histolytica in culture. I. Demonstration of toxicity of washed erythrocytes to a strain of E. histolytica. Am J Trop Med Hyg 1961;10:10–16.
93.
Shaffer JG, Iralu V. The Selective Ability Of Strains Of Entamoeba Histolytica To Hemolyse Red Blood Cells. Am J Trop Med Hyg 1963;12:315–317.
94.
Shiga K. Chosen Igakkai Zassi 1911;1:12–24.
95.
Soh CT, et al. Han-Kook Eui-Yak 1959;2(2):81–83.
96.
Soh CT, et al. Yonsei Med J 1961;2:31–41.
97.
Soh CT, et al. Yonsei Med J 1969;10(2):181–191.
98.
Soh CT. Yonsei Rep Trop Med 1973;4:102–125.
99.
Soh CT, et al. Korean Central Med J 1974;26(2):1–5.
100.
Soh CT, et al. Yonsei Rep Trop Med 1978;9(1):57–62.
101.
Solomon GB. Exp Parasit 1964;18:374.
102.
Sun MH, et al. Korean Central Med J 1966;10(5):615–620.
103.
Teodorovic S, Ingalls JW, Greenberg L. Effects of corticosteroids on experimental amoebiasis. Nature 1963;197:86–87.
104.
Thong YH, Ferrante A, Shepherd C, Rowan-Kelly B. Resistance of mice to Naegleria meningoencephalitis transferred by immune serum. Trans R Soc Trop Med Hyg 1978;72(6):650–652.
105.
Villarejos VM. J Parasitol 1962;48:194.
106.
Willaert E, et al. Prostologica 1973;9:417–426.
107.
Yamaguchi R. Chosen Igakkai Zassi 1913;4:1–12.
108.
Yang JK, et al. Yonsei Rep Trop Med 1972;3:60–72.
109.
Yang J, Scholten T. Dientamoeba fragilis: a review with notes on its epidemiology, pathogenicity, mode of transmission, and diagnosis. Am J Trop Med Hyg 1977;26(1):16–22.
110.
Yoon CM. Chonnam Med J 1965;2(1):93.
111.
Yoon KC, et al. Korean New Med J 1966;9(6):577–582.
PDF Links
Full text via DOI
Download Citation 
