Abstract
Introduction: Amoebic colitis is a common worldwide infection with a risk of serious complications, including invasive intestinal and extra-intestinal disease. Although newer tests are available, the mainstay of diagnosis remains stool microscopy. Early treatment with metronidazole followed by paromomycin generally results in a clinical cure. Case presentation: We describe a case of fulminant colitis secondary to Entamoeba histolytica requiring bowel resection that went unrecognized until the operative histology was reviewed. Conclusion: Clinicians worldwide need to be aware of this condition, particularly in patients originating from endemic areas, to ensure early diagnosis and appropriate treatment leading to optimal clinical outcomes.
Highlights
Amoebic colitis is a common worldwide infection with a risk of serious complications, including invasive intestinal and extra-intestinal disease
We report an encounter with a patient in whom diagnosis was delayed resulting in progression to fulminant colitis
Broad-spectrum antibiotics are often indicated in fulminant disease where bacterial translocation across the damaged intestinal wall can occur, and therapeutic aspiration of a liver abscess is occasionally required as adjunctive therapy (Petri, 2003)
Summary
Entamoeba histolytica is a common, well-recognized pathogenic amoeba, associated most often with intestinal and extra-intestinal infection. A 74-year-old previously healthy Indian man visiting family in Melbourne, Australia, presented to our emergency department with severe abdominal pain following 2weeks of worsening dysentery. On arrival he was hypotensive, tachycardic and hypothermic with signs of peritonitis. Clinical improvement continued and he was discharged from hospital feeling well 2 weeks after his initial presentation.
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