Diagnostic Code 7321 · 38 CFR §4.114
Amebiasis is an intestinal infection caused by the protozoan parasite Entamoeba histolytica, contracted from contaminated water or food. After an acute episode of bloody diarrhea, abdominal cramping, and fever, the parasite can persist in the colon for years and cause chronic recurring symptoms. In a minority of cases, the parasite breaches the intestinal wall and reaches the liver, producing an amoebic liver abscess that can be life-threatening if untreated. Veterans who deployed to regions where the parasite is endemic — large parts of Asia, Africa, Central America, and South America — are at elevated risk, particularly those who consumed local water or food during forward operations. Under DC 7321, the VA rates amebiasis on the chronic residuals: how often symptoms recur, how severe the gastrointestinal disturbance remains, and whether liver involvement is present.
| Rating | Criteria |
|---|---|
| 0% | History of amebiasis with no current symptoms — the parasite has been cleared by treatment and follow-up stool studies are negative. |
| 10% | Mild chronic residuals — occasional abdominal cramping, intermittent loose stools, mild dyspepsia, or other low-grade gastrointestinal symptoms that respond to outpatient management. |
| 30% | Moderate chronic residuals — recurring episodes of diarrhea, persistent abdominal pain, weight loss, anemia, or evidence of liver involvement such as a treated hepatic abscess with residual scarring or functional impairment. |
Stool studies — either microscopy for trophozoites or cysts, antigen testing, or PCR — confirm the diagnosis during an active episode. Serology can support a historical diagnosis when current stool studies are negative but symptoms continue. Colonoscopy with biopsy showing characteristic flask-shaped ulcers documents intestinal involvement. Abdominal ultrasound, CT, or MRI of the liver identifies amoebic abscesses past or present. A symptom diary covering several months captures the recurrence pattern that drives the rating tier. Service medical records or post-deployment medical evaluations documenting the initial diagnosis or treatment establish the in-service onset. Records of antibiotic regimens (metronidazole, paromomycin, iodoquinol) confirm the chronic management burden.
Yes. The parasite can persist in the colon for years, and chronic symptoms can develop or recur long after the initial exposure. Service connection runs through the deployment history (DD-214 plus deployment records to an endemic region) plus the current diagnosis. A nexus opinion from a gastroenterologist or infectious disease specialist connecting the in-service exposure to the current chronic disease state closes the case.
No. Amebiasis is caused by Entamoeba histolytica and is rated specifically under DC 7321. Giardiasis (Giardia lamblia) and other protozoal infections are different conditions with different rating codes. General traveler's diarrhea without a specific organism identified is typically rated under chronic enteritis (DC 7325) or chronic enterocolitis (DC 7326). Getting the right diagnosis matters because the rating frameworks differ.
A treated amoebic liver abscess can leave residual scarring, persistent liver enzyme elevation, or functional impairment. Those residuals support the 30% rating tier under DC 7321, and they can also be evaluated separately under the liver injury code (DC 7311) if the functional loss justifies it. Imaging showing the scar plus liver function lab work establishes the basis.