An Unusual Cause of Chronic Diarrhea

Abstract

Question: A male patient presented with recurrent episodes of diarrhea that developed after a Caribbean cruise 1 year ago. He also complained of severe epigastric pain, arthralgias, myalgias, significant weight loss, and ocular symptoms, which were diagnosed as iritis. He had undergone an extensive workup at an outside hospital including a colonoscopy, which showed colonic mucosal congestion, loss of vascular architecture, and diverticulosis. Biopsies were interpreted as mild active chronic colitis and the possibility of inflammatory bowel disease was raised.