Rapid Detection of Entamoeba histolytica Using FilmArray Gastrointestinal Panel: Enhancing Early Treatment and Outcomes

Clin Lab. 2024 Dec 1;70(12). doi: 10.7754/Clin.Lab.2024.240716.

Abstract

Background: Entamoeba histolytica, a protozoan parasite, is responsible for intestinal amebiasis and can cause severe complications. It is prevalent in tropical and subtropical regions and is a significant health concern in developing countries. Traditional diagnostic methods often delay the diagnosis, leading to prolonged patient suffering and increased risk of complications.

Methods: We report the case of a 59-year-old HIV-positive man on Odefsey, who presented with a week-long history of abdominal pain and diarrhea. Initial stool analysis suggested bacterial colitis, and empirical treatment with levofloxacin was initiated. However, the patient's condition worsened, resulting in hospitalization. Laboratory findings included elevated white blood cell count and high-sensitivity C-reactive protein, with low plasma sodium and potassium levels. Stool bacterial cultures were negative for common pathogens.

Results: Rapid diagnosis was achieved using the FilmArray GI Panel, which detected E. histolytica within an hour. Subsequent stool microscopy suggested the presence of E. histolytica/E. dispar cysts. Prompt antiamoebic therapy with metronidazole and paromomycin resulted in significant clinical improvement. The case was reported to the Centers for Disease Control (CDC) as a Category II notifiable disease.

Conclusions: This case underscores the critical role of the FilmArray GI Panel in the rapid detection of E. his-tolytica, facilitating timely and effective treatment. Early diagnosis using advanced molecular diagnostics significantly improves patient outcomes and should be incorporated into routine clinical practice for managing gastrointestinal infections.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Antiprotozoal Agents / therapeutic use
  • Diarrhea / diagnosis
  • Diarrhea / drug therapy
  • Diarrhea / microbiology
  • Diarrhea / parasitology
  • Dysentery, Amebic / diagnosis
  • Dysentery, Amebic / drug therapy
  • Early Diagnosis
  • Entamoeba histolytica* / isolation & purification
  • Entamoebiasis* / diagnosis
  • Entamoebiasis* / drug therapy
  • Feces* / microbiology
  • Feces* / parasitology
  • Humans
  • Male
  • Metronidazole / therapeutic use
  • Middle Aged
  • Paromomycin / therapeutic use
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Metronidazole
  • Paromomycin