Diagnosis Of Amebic Colitis Research Articles

Spectrum of CT findings in amebic colitis.

Entamoeba histolytica is distributed throughout the world. Invasive amebiasis affects millions of people globally, and the associated complications cause 40,000-100,000 deaths per year. In countries where fecal-oral transmission is unusual, amebic colitis is not common, and the infection may be seen in travelers to and emigrants from endemic areas. Without adequate treatment, amebic colitis may develop into fulminant and become rapidly fatal. With the current increase in global mobility, amebic colitis should be suspected even in patients not in the endemic areas. CT plays an important role in the diagnosis of amebic colitis by demonstrating the presence of colitis with the typical involvement of the cecum and rectum. Pathological features of atypical involvement are also demonstrated. Since preoperative diagnosis can reduce the mortality associated with necrotizing colitis, radiologists need to recognize the typical as well as atypical CT findings of amebic colitis. Considering this requirement, this paper aims to describe the histopathologic features of amebic colitis and to illustrate the spectrum of corresponding CT findings.

Atypical fulminant presentation of amebiasis in chronic kidney disease patient on maintenance hemodialysis

Amebiasis is a common cause of dysentery in India and can have an atypical fulminant course with negative serological tests in immunosuppressed individuals such as chronic kidney disease (CKD). We present a patient of CKD on dialysis who presented with features of dysentery with negative blood and serology workup. The diagnosis of amebic colitis was made after colonoscopy and histopathology which revealed amebic trophozoites and her symptoms abated after appropriate therapy. This case report illustrates the need for colonoscopy and histopathology for definite diagnosis of fulminant presentation of amebic colitis in an immunosuppressed individual such as CKD.

A clinical study of fulminant amebic colitis

The administration of metronidazole is generally effective to treat amebic colitis. Fulminant amebic colitis is relatively rare, and it is associated with a high mortality rate. Three cases of fulminant amebic colitis were diagnosed in our hospital between 1993 and 2014. One of these patients died despite our efforts. Amebic colitis often presents with no obvious risk factors and with atypical clinical symptoms. Therefore, the diagnosis of amebic colitis can be difficult. Early diagnosis is the most important factor in successful treatment of fulminant amebic colitis. The present cases demonstrate that it is important to consider the possibility of amebic colitis during evaluation of the acute abdomen.

The Varied Manifestations of Amebic Colitis

Purpose: Invasive amebiasis is common worldwide, but is seen infrequently in the United States. It is often not included in the initial differential diagnosis; however, it is associated with considerable morbidity in patients residing in or traveling to endemic areas. We report a series of interesting cases of patients with amebic colitis in a United States-Mexico border city to alert physicians to the varied manifestations of this condition. Methods: We analyzed the clinical and endoscopic manifestations of amebic colitis in patients identified in a retrospective chart review of patients who presented to Thomason General Hospital in El Paso, Texas between 10/99 and 4/09. Criteria for amebic colitis included demonstration of motile hematophagous trophozoites of Entamoeba histolytica in stool or histologic confirmation of invasive amebiasis in colonic tissue. Results: Nine patients were diagnosed with amebic colitis. Median age was 46 (range 38-83), 5 were males, and all were Hispanic. The main symptoms were diarrhea (67%), abdominal pain, hematochezia, abdominal distension, and fever. Two patients presented with gastrointestinal bleeding, not associated with diarrhea. Median duration of symptoms was from 7 to 14 days. The main physical finding was abdominal tenderness in 6/8 (75%) and an abdominal mass in 1 patient. The diagnosis of amebic colitis was established in the following ways: 7 patients by colonoscopy with biopsy, 1 by surgery for colonic obstruction, and 1 by positive stool smear done to evaluate dysentery. There was histologic confirmation of colonic amebiasis in 7/8 (88%) in whom tissue was obtained. All 7 patients in whom colonoscopy was done had inflammation with rectosigmoid involvement and 6/7 (86%) had ulcerations present. Infection resolved after treatment with metronidazole in most patients; however, 1 patient developed a liver abscess and another developed colonic perforation. Conclusion: 1) The occurrence of amebic colitis in this United States-Mexico border city hospital population was low, but potentially life-threatening. 2) The most common symptom was diarrhea, but physicians should be alert to the less common presentations of primarily gastrointestinal bleeding or of a surgical abdomen. 3) Of note, rectosigmoid involvement is typically found on colonoscopy.

Amebic Colitis Masquerading as Acute Inflammatory Bowel Disease

Amebic colitis needs to be considered in the differential diagnosis of infectious colitis or inflammatory bowel disease (IBD). Misdiagnosing amebic colitis as idiopathic inflammatory disease may be fatal. Although stool studies remain the initial approach to diagnosis, the incidence of false-negatives associated with this method is high. We report two cases of amebic colitis presenting as inflammatory bowel disease in which the diagnosis of amebic colitis was made by serology. Neither patient had any risk factors for acquiring amebiasis. Paired serology for amebic infections (2-4 weeks apart) should be performed in patients being evaluated for infectious colitis and inflammatory bowel disease.

Intestinal amebiasis. A roentgen analysis of 19 cases including 2 case reports.

Various roentgen features of 19 cases of amebic colitis are analyzed and compared with granulomatous colitis, ulcerative colitis and other ulcerative diseases of the colon.The lesions of amebic colitis, in general, had a shaggy contour; the eccentric lesions were almost as common as the concentric lesions. The left-sided colitis was as common as the right-sided colitis and diffuse colitis was present only in the form of multiple skip lesions. Skip lesions were common. Deep and superficial ulcers of varying types were noted and had, in general, a ragged appearance. Various types of unspecific haustral and mucosal changes were noted. The annular lesions of amebomas were distinguished from carcinomas in most cases by their gradually tapering ends, relatively well preserved mucosa and response to antiamebic therapy.The diagnosis of amebic colitis was strongly considered when the cone-like cecum was accompanied by an intact terminal ileum and a skip lesion elsewhere in the colon. The shaggy contour of the lesi...

Pitfalls in the diagnosis of amebic colitis.

We have chosen four cases illustrating pitfalls and difficulties in the diagnosis of amebic colitis and the disastrous results of misdiagnosis. In many instances the correct diagnosis is not reached because of insufficient awareness of the possibility of the disease on the part of the physician, or because of his reliance on examination of the stool alone to exclude amebiasis. In other cases, as in amebic appendicitis or amebic typhlitis, the clinical picture may be identical to that of bacterial appendicitis.

Rectal biopsy in the diagnosis of amebic colitis.

Rectal biopsy in the diagnosis of amebic colitis.