What Causes Presence Of Amoeba In Stool?

Posted on Sat, 16 Apr 2016

Question: hi, my dad's doctor is saying that my dad's stool sample has presence of amoeba in pus cells even if the lab report shows negative for amoeba. He insists that there is even given the lab results. He has been randomly giving my 100 year old dad flagyl. I have asked my brother to have a second opinion from a gastroenterologist. What is your advise. I fear for my dad's health. He has never been this sick in his entire life given his age. I fear that the antibiotic he is taking is not appropriate because there is no lab result to indicate this medication. Please guide me what else I must consider.

Answered by Dr. Dr. Ivan Romich (26 minutes later)

Brief Answer:
Further tests required

Detailed Answer:
Hi and welcome.
Firstly, if his conditions are worsening, then he should be admitted in hospital and have intravenous fluids replacement and intravenous antibiotics, blood transmission.
Secondly, amoeba is typically diagnosed by stool microbiological analysis and regular blood tests are nonspecifc and in most cases leuckocytosis is seen, eosinophiles may be elevated. So if amoeba is present in stool then there is obviously parasitic colitis.
However, his red blood count is worrying and this may indicate some another pathological process and it requires further tests including colonoscopy, kidney tests and liver work up. I think that flaggyl should be continued, he should be hydrated adequately and take probiotics. Wish you good health. Regards

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Ivan Romich (46 hours later)

Doc, my dad doesn't want to go to the hospital. I want to suggest iron, erythropoietin and vit B 12 for this - is this ok? I have asked for more labs on liver function and his GFR. I only got his creatininine 5.58, BUN 64. Also, his L arm is beginning to bruise

Answered by Dr. Dr. Ivan Romich (40 hours later)

Brief Answer:
see next

Detailed Answer:
hi.
These are pathologic kidney markers. This is sign of renal insufficinecy, but I suppose that he is under control of nephrologist.
Vitamin B12 and iron are justified if there is anemia which is caused by malabsorption or lack of intake. It includes cases where B12 and iron cant be sufficiently adsrorbed in intestines such ad prolonged diarheass, crohns disease, severe gastritis or perncious anemia. ALso, if he doesnt take it in food in adequae dosage.
Pernicious anemia is cahracterized by low red blood count and higher MCV abd MCHC while iron defficiency anmeia will have normal MCV and low red blood count with low hematocrit.

These supplements should not be taken with no indication.
Eritropoetin is used for anemia if there is renal cause of it and this is possible in his case since BUN and creatinin levels are indicating renal disease.

TO be sure what to do you should check red blood count and hemoglobin volumes, feritine in blood, B12 level in blood and do tests for hemolytic anemia.

ALl types of anemias may be triggered by intestinal infections such as amebiasis.

Wish you good health. Regards

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Above answer was peer-reviewed by : Dr. Naveen Kumar