What is the prognosis of amebiasis?

Updated: Jul 19, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Intestinal infections due to amebiasis generally respond well to appropriate therapy, though it should be kept in mind that previous infection and treatment will not protect against future colonization or recurrent invasive amebiasis.

Asymptomatic intestinal amebiasis occurs in 90% of infected individuals. However, only 4%-10% of individuals with asymptomatic amebiasis who were monitored for 1 year eventually developed colitis or extraintestinal disease. [17]

With the introduction of effective medical treatment, mortality has fallen below 1% for patients with uncomplicated amebic liver abscess. However, amebic liver abscess can be complicated by sudden intraperitoneal rupture in 2-7% of patients, and this complication leads to a higher mortality. [4]

Case-fatality rates associated with amebic colitis range from 1.9% to 9.1%. Amebic colitis evolves to fulminant necrotizing colitis or rupture in approximately 0.5% of cases; in such cases, mortality may exceeds 40% [43] or even, according to some reports, 50%.

Pleuropulmonary amebiasis has a 15-20% mortality rate. Amebic pericarditis has a case-fatality rate of 40%. Cerebral amebiasis carries a very high mortality (90%).

A study of 134 deaths in the United States from 1990 to 2007 found that mortality was highest in men, Hispanics, Asian/Pacific Islanders, and people aged 75 years or older. [22] An association with HIV infection was also observed. Although deaths declined during the course of the study, more than 40% occurred in California and Texas. US-born persons accounted for the majority of amebiasis deaths; however, all of the fatalities in Asian/Pacific Islanders and 60% of the deaths in Hispanics were in foreign-born individuals.


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