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INTRODUCTION

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Amoebas at the start

Were not complex;

They tore themselves apart

And started sex.

—Arthur Guiterman: The Light Guitar

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SARCOMASTIGOPHORA—THE AMEBAS—GROUP CHARACTERISTICS

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The Sarcomastigophora include both the amebas and flagellate groups. Because of their divergent organization and medical importance, they are considered in separate chapters. The amebas are characterized by movement involving cytoplasmic streaming dependent upon pseudopodia formation. These projections of the relatively solid ectoplasm are formed by streaming of the inner, more liquid endoplasm. They move the ameba forward and, incidentally, engulf and internalize food sources found in its path. Amebas multiply by simple binary fission. Most amebas, when faced with a hostile environment, can produce an external cyst wall that surrounds and protects them. These cysts may survive for prolonged periods under conditions that would rapidly destroy the motile trophozoite. Most amebas belong to free-living genera. They are widely distributed in nature, being found in literally all bodies of standing fresh water. Few free-living amebas produce human disease, although two genera, Naegleria and Acanthamoeba, have been implicated occasionally as causes of meningoencephalitis and keratitis.

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Several genera of amebas, including Entamoeba, Endolimax, and Iodamoeba, are obligate commensalistic parasites of the human alimentary tract and are passed as cysts from host to host by the fecal–oral route. Most amebas are amitochondriate, presumably because of the anaerobic conditions under which they exist in the colon. Only one, Entamoeba histolytica, regularly produces disease; it has been recently subdivided into two morphologically identical but genetically distinct species, an invasive pathogen that retains the species appellation “histolytica” and a commensal organism, now designated Entamoeba dispar. The two species can be differentiated by isoenzyme analysis, antibodies to surface antigens, and DNA markers.

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ENTAMOEBA HISTOLYTICA

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Overview

Entamoeba histolytica is an intestinal ameba transmitted between humans. Amebiasis is found worldwide and is caused by the potentially pathogenic E histolytica. Approximately 10% of patients with this parasite will have gastrointestinal symptoms and 1% will experience extraintestinal disease which can be life-threatening. Gastorintestinal symptoms may include intermittent diarrhea with abdominal pain. Occasionally, severe dysentery with abdominal cramping and a high fever can occur. Extraintestinal extension depends on the presence of a galactose-specific lectin (Gal/GalNAc) capable of mediating attachment of the organism to colonic mucosa followed by contact dependent cytotoxicity and blood passage of trophozoites to various organs. Entamoeba dispar, which is morphologically identical to E histolytica, accounts for the vast majority of E histolytica-like infections. Treatment is not required for E dispar.

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PARASITOLOGY

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Entamoeba histolytica is found throughout the world and is the causative agent of diarrhea and amebic dysentery. Infections may spread to extraintestinal sites and become life-threatening. Close to 500 million people are thought to be infected at any one time, but most of these are likely due to the morphologically identical E ...

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