Pyogenic abscess is ruled out there is no response to treatment in three to five days rupture is imminent pericardial spread is imminent Metronidazole, 750 mg orally three times daily for five days, then paromomycin, 500 mg three times daily for seven daysĬhloroquine (Aralen), 600 mg orally per day for two days, then 200 mg orally per day for two to three weeks (higher relapse rates) Metronidazole, 750 mg orally three times daily for 10 days Paromomycin, 500 mg orally three times daily for seven daysĭiloxanide furoate (Furamide), 500 mg orally three times daily for 10 days (available from CDC) Iodoquinol (Yodoxin), 650 mg orally three times daily for 20 days Use iodine disinfection of nonbottled water. Use proper sanitation to eradicate cyst carriage.Īvoid eating unpeeled fruits and vegetables. Intestinal disease: use both luminal amebicide (for cysts) and tissue amebicide (for trophozoites) Packed red blood cells (as needed) can minimize risk of volume overload in severely hypoproteinemic patients.Ĭonfirm eradication with follow-up stool examination two weeks after discontinuation of treatment. Iron supplementation is beneficial even before diagnosis or treatment initiation. Pyrantel pamoate, 11 mg per kg (maximum of 1 g) once Mebendazole, 100 mg orally twice daily for three days Iodine purification tablets for eight hoursĪncylostoma duodenale, Necator americanus Heat water to 70 C (158 F) for 10 minutes Use proper sewage disposal and water treatment (flocculation, sedimentation, filtration, and chlorination).Ĭonsume only bottled water in endemic areas. Pregnant women with severe symptoms: paromomycin (Humatin), 500 mg orally four times daily for seven to 10 days metronidazole is acceptable.Ĭhildren: albendazole, 400 mg orally for five daysĪsymptomatic carriers in developed countries: treat using regimen for adults or children.Īsymptomatic carriers in developing countries: not cost-effective to treat because of high reinfection rate. Pregnant women with mild symptoms: consider deferring treatment until after delivery. If persistent, repeat treatment in two weeks.ĭo not give to children younger than two years.Īdults: Metronidazole (Flagyl), 250 mg orally three times daily for five to seven days Secondary: Pyrantel pamoate (Pin-Rid), 11 mg per kg (maximum of 1 g) orally once orĪlbendazole (Valbazen), 400 mg orally once Primary: Mebendazole (Vermox), 100 mg orally once Careful sanitation and use of peeled foods and bottled water are preventive. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Preventive measures include wearing shoes and treating sewage. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. Stool ova and parasite studies are diagnostic. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Diagnosis can be made using the “cellophane tape test.” Treatment includes mebendazole and household sanitation. vermicularis, or pinworm, causes irritation and sleep disturbances. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. Intestinal parasites cause significant morbidity and mortality.
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