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Journal of Clinical Microbiology, September 2000, p. 3235-3239, Vol. 38, No. 9
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Diagnosis of Amebic Liver Abscess and Intestinal Infection with the TechLab Entamoeba histolytica II Antigen Detection and Antibody Tests

Rashidul Haque,1 Nasir Uddin Mollah,2 Ibne Karim M. Ali,2 Khorshed Alam,2 Aleida Eubanks,3 David Lyerly,3 and William A. Petri Jr.4,*

Centre for Health and Population Research, ICDDR,B,1 and Department of Microbiology and Hepatology, Bangabandhu Sheikh Mujib Medical University,2 Dhaka, Bangladesh, and TechLab, Inc., Blacksburg,3 and Departments of Medicine, Microbiology and Pathology, University of Virginia, Charlottesville,4 Virginia

Received 21 March 2000/Returned for modification 6 June 2000/Accepted 22 June 2000

A noninvasive diagnostic test for amebic liver abscess is needed, because amebic and bacterial abscesses appear identical on ultrasound or computer tomography and because it is rarely possible to identify Entamoeba histolytica in stool specimens from patients with amebic liver abscess. Here we report a method of detection in serum of circulating E. histolytica Gal/GalNAc lectin to diagnose amebic liver abscess, which was used in patients from Dhaka, Bangladesh. The TechLab E. histolytica II test (which differentiates the true pathogen E. histolytica from Entamoeba dispar) detected Gal/GalNAc lectin in the sera of 22 of 23 (96%) amebic liver abscess patients tested prior to treatment with the antiamebic drug metronidazole and 0 of 70 (0%) controls. After 1 week of treatment with metronidazole, 9 of 11 (82%) patients became serum lectin antigen negative. The sensitivity of the E. histolytica II antigen detection test for intestinal infection was also evaluated. Antigen detection identified E. histolytica infection in 50 samples from 1,164 asymptomatic preschool children aged 2 to 5 years, including 16 of 16 (100%) culture-positive specimens. PCR analysis of stool specimens was used to confirm that most antigen-positive but culture-negative specimens were true-positive: PCR identified parasite DNA in 27 of 34 (79%) of the antigen-positive, culture-negative stool specimens. Antigen detection was a more sensitive test for infection than antilectin antibodies, which were detected in only 76 of 98 (78%) amebic liver abscess patients and in 26 of 50 (52%) patients with intestinal infection. We conclude that the TechLab E. histolytica II kit is a sensitive means to diagnose hepatic and intestinal amebiasis prior to the institution of metronidazole treatment.

* Corresponding author. Mailing address: P.O. Box 801340, University of Virginia Health System, Charlottesville, VA 22908-1340. Phone: (804) 924-5621. Fax: (804) 924-0075. E-mail: wap3g{at}virginia.edu.

Journal of Clinical Microbiology, September 2000, p. 3235-3239, Vol. 38, No. 9
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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