Toxic Megacolon due to Fulminant Amebic Colitis in a non Endemic Area

Abstract

We report a case of fulminant necrotizing colitis and toxic megacolon in a middle-aged woman, due to infection with Entamoeba histolytica acquired in a non endemic zone of amebiasis, and requiring emergent total colectomy due to the occurrence of colon perforation and peritonitis. Fulminant colitis is a rare complication of amebiasis, which has been only exceptionally reported in the absence of a recent travel in endemic areas. In the case presented herein, we discuss the possible role of the use of large doses of loperamide, as well as that of a co-infection with Norovirus, in triggering the fulminant course of the disease. doi: http://dx.doi.org/10.4021/jmc900w