Colonic perforation in unsuspected amebic colitis

Unsuspected amebic colitis presenting as inflammatory bowel disease, as in our patient, has been previously reported (4, 7, 8). Misdiagnosis, delay in antibiotic treatment, and institution of immunosuppression were the result of failure to identify the parasite in stool specimens and have resulted i...

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Bibliographic Details
Published in:Digestive diseases and sciences 2000-09, Vol.45 (9), p.1836-1841
Main Authors: ABBAS, Maher A, MULLIGAN, David C, RAMZAN, Nizar N, BLAIR, Janis E, SMILACK, Jerry D, SHAPIRO, Michael S, LIDNER, Thomas K, OLDEN, Kevin W
Format: Article
Language:English
Subjects:
Acute Disease
Amibiasis
Biological and medical sciences
Colitis, Ulcerative - diagnosis
Colonic Diseases - etiology
Colonic Diseases - pathology
Diagnosis, Differential
Dysentery, Amebic - complications
Dysentery, Amebic - diagnosis
Dysentery, Amebic - pathology
Female
Human protozoal diseases
Humans
Infectious diseases
Intestinal Perforation - etiology
Liver Abscess, Amebic - complications
Liver Abscess, Amebic - diagnosis
Medical sciences
Middle Aged
Parasitic diseases
Protozoal diseases
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Summary:Unsuspected amebic colitis presenting as inflammatory bowel disease, as in our patient, has been previously reported (4, 7, 8). Misdiagnosis, delay in antibiotic treatment, and institution of immunosuppression were the result of failure to identify the parasite in stool specimens and have resulted in suffering, morbidity, mortality, and surgery. In all previously reported cases, routine stool studies failed to identify E. histolytica (4, 7, 8). The correct diagnosis was only established after reviewing the surgical specimen or biopsies obtained endoscopically. Because the erroneous diagnosis of inflammatory bowel disease can lead to disastrous complications, it is imperative to exclude amebic colitis prior to undertaking steroid therapy, especially in patients with a prior history of travel to or residence in areas with endemic E. histolytica (17). We recommend obtaining at least three stool specimens for microscopic examination, as well as testing for serum amebic antibody. Patients should submit fresh stool specimens directly to the laboratory to allow for prompt diagnostic evaluation. Such an approach might lead to the improved diagnosis of amebiasis.
ISSN:0163-2116
1573-2568
DOI:10.1023/a:1005561607130