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Entamoeba histolytica is a protozoan parasite that infects an estimated 34 to 50 million people per year worldwide, and kills 100,000 individuals annually. The disease caused by E. histolytica, amebiasis, is common in tropical areas with poor sanitary conditions but is also endemic in the US with the prevalence of E. histolytica infection estimated to be 4%. The most common clinical manifestation of infection with E. histolytica is amoebic diarrhea without dysentery; however, more severe cases can result in amoebic dysentery, which is diarrhea with mucous and visible or microscopic blood, severe abdominal pain, fever, and elevated fecal lysozyme. Occasional asymptomatic carriage is possible.
Route of infection is fecal oral via contaminated food or water, especially related to international travel (Mexico, China, and South East Asia). Steroids are contraindicated and may exacerbate symptoms. Treatment recommended; Metronidazole 500 mg three times daily for 7-10 days, Tinidazole 2 g daily for 3 days, or Nitazoxanide 500 mg twice daily for 3 days followed by paromomycin 25 mg/kg/day in 3 divided doses for 7 days, oral rehydration therapy and symptomatic treatment of fever. No specific herbal parasiticides are listed in scientific literature. Allium sativum (garlic), Berberis vulgaris (barberry), Berberis aquifolium (Oregon grape), Pimpinella anisum (anise), Artemisia annua (wormwood), Mentha crispa (curly mint), and Juglans nigra (black walnut) may be considered or used adjunctively, based on historical uses of these herbs.
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