Entamoeba histolytica

Considering the risk of spread as well as the risk of invasive disease, all E. histolytica* infections should be treated (even if asymptomatic).

There are 2 types of medications used for amebic colitis**: tissue agents (to eliminate the invading trophozoites) and luminal agents (to eradicate the intraluminal cysts).

Treatment for symptomatic patients: 1. Tissue agent - Metronidazole 750 mg three times daily for 10 days (children: 50 mg/kg/day divided in 3 doses, max 750 mg per dose) 2. Luminal agent (given after the metronidazole course) - Paromomycin 25 to 35 mg/kg/day divided in 3 doses for 7 days Treatment for asymptomatic patients: Luminal agent only ​- Paromomycin 25 to 35 mg/kg/day divided in 3 doses for 7 days​ Test-of-cure: Protozoal screen 1 month post-treatment

​* Entamoeba dispar infections do not require treatment.

** These treatment recommendations only apply to amebic colitis. If an amebic abscess is suspected (refugee with fever and right upper quadrant pain), imaging (ultrasound or CT) should be rapidly performed. If an abscess is found, management should be discussed with an Infectious Diseases specialist. Stool microscopy and PCR will usually be negative in patients with an amebic abscess.​