Predisposing events:
(1) amebic dysentery
(2) cutaneous fistula draining a hepatic abscess
(3) ischiorectal fistula
(4) anal intercourse (pederasts, homosexuals, bisexuals, etc.)
(5) inoculation into surgical site during colonic or hepatic surgery
(6) autoinoculation
Persons at risk:
(1) poverty with poor hygiene
(2) malnutrition
(3) immune deficiency
General features of lesions:
(1) The initial lesion is a pustule or area of erythema.
(2) This becomes a painful, ragged ulcer with raised edges and an erythematous halo.
(3) The ulcer enlarges rapidly and may be foul smelling with ulcer base covered by pus or necrotic debris.
(4) The infection may be fatal if untreated.
|
Exposure
|
Location of Lesions
|
|
amebic dysentery
|
perianal
|
|
anal intercourse
|
perianal, inguinal, penis, vulva
|
|
fistula
|
about the opening
|
|
surgical site
|
incision line
|
Diagnosis:
(1) examination of scrapings or biopsies from ulceration
(2) stool for ova and parasites
(3) serology
