Volume 187 - Issue 6
Amoebiasis: current status in Australia
Author: Chien-Ching Hung
Med J Aust 2007; 187 (6): 372-374. || doi: 10.5694/j.1326-5377.2007.tb01293.x
Published online: 17 September 2007
Published online: 17 September 2007
To the Editor: I read with great interest the recent updated review of amoebiasis by van Hal and colleagues1 and their previous letter2 describing three cases of locally acquired amoebiasis due to Entamoeba histolytica in Australian men who have sex with men (MSM). These articles should alert clinicians to the emergence of invasive amoebiasis and the possibility of person-to-person transmission of E. histolytica through oral–anal or oral–genital sex among MSM in developed countries. The same phenomenon has been reported in Taiwan3 and Japan.4
The prevalence or incidence of intestinal amoebiasis among people at risk may have been underestimated in the past, as microscopy of stool specimens has lower sensitivity and specificity than E. histolytica antigen detection methods for diagnosing the disease.1,5 Cases of amoebiasis may evade detection using the diagnostic algorithm proposed by van Hal and colleagues,1 which suggests using microscopy of stool specimens to detect E. histolytica complex followed by confirmation with specific antigen detection methods or molecular methods. To increase diagnostic sensitivity and specificity, I suggest revising the diagnostic algorithm for intestinal amoebiasis in developed countries to include more accurate first-line detection methods. For example, specific antigen detection methods or polymerase chain reactions, as proposed by Tanyuksel and Petri,5 could be incorporated.
References
- van Hal SJ, Stark DJ, Fotedar R, et al. Amoebiasis: current status in Australia. Med J Aust 2007; 186: 412-416. 0_BABGGDBH
- Stark DJ, Fotedar R, Ellis JT, Harkness JL. Locally acquired infection with Entamoeba histolytica in men who have sex with men in Australia [letter]. Med J Aust 2006; 185: 417. 0_pgfId-1382898
- Hung CC, Deng HY, Hsiao WH, et al. Invasive amebiasis as an emerging parasitic disease in patients with human immunodeficiency virus type 1 infection in Taiwan. Arch Intern Med 2005; 165: 409-415. 0_pgfId-1373379
- Nozaki T, Kobayashi S, Takeuchi T, Haghighi A. Diversity of clinical isolates of Entamoeba histolytica in Japan. Arch Med Res 2006; 37: 277-279. 0_i1091830
- Tanyuksel M, Petri WA Jr. Laboratory diagnosis of amebiasis. Clin Microbiol Rev 2003; 16: 713-729. 0_i1091832