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Amoebic dysentery — DTM&H MCQ

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ModerateProtozoal infectionsAmoebic dysenteryDTM&H

A 28-year-old traveller has bloody diarrhoea after travel in Bangladesh. Stool PCR detects Entamoeba histolytica and he is systemically well. What is the most appropriate treatment?

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Correct answer: B — Metronidazole followed by luminal agent

Metronidazole followed by luminal agent is the single best answer because invasive amoebiasis needs tissue-active therapy followed by a luminal agent to eradicate intestinal cyst carriage. Metronidazole without luminal therapy is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that metronidazole alone may improve symptoms but leaves ongoing carriage and relapse risk.

Reference: Manson's Tropical Diseases; WHO neglected tropical diseases guidance; CDC DPDx