Prelevance of parasitic etiology in patients with hemorrhagic rectocolitis. Implication of Entamoeba histolytica infection

Entamoeba histolytica (Schaudinn, 1903), a protozoan with worldwide distribution, estimated to infect about 500 million people worldwide and registering higher rates in tropical countries, is also present in Romania. It has been difficult to distinguish, until recently, from the morphologically identical, but no pathological Entamoeba dispar. A number of 148 persons diagnosed with hemorrhagic rectocolitis were hospitalized at Fundeni Clinical Institute in the Gastroenterology Department between May 2007 and September 2008. Giardia lamblia, Entamoeba coli, Blastocystis hominis, E. histolytica protozoan species, and Clostridium difficile as unique etiologies, as well as the association of Giardia lamblia and Clostridium difficile, respectively Entamoeba coli and Clostridium difficile were detected in 139 patients. All patients were tested by ELISA (IgM detection) for the presence of E. histolytica, 3% of them being positive. Two of the positive patients belonged to high risk groups (male homosexuals and traveling in warmer areas endemic for E. histolytica), while one was infected locally. Taking into consideration the global warming registered also in Romania, especially during the winter time, it could be plausible that over-wintering mortality of E. histolytica cysts may decrease, hence leading to an increase in the future incidence of this infection in our country.