Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

• Published in: World journal of gastroenterology : WJG 2009-07, Vol.15 (27), p.3445-3447
• Main Authors: Hanaoka, Noboru, Higuchi, Katsuhiko, Tanabe, Satoshi, Sasaki, Tohru, Ishido, Kenji, Ae, Takako, Koizumi, Wasaburo, Saigenji, Katsunori
• Format: Article
• Language: English
• Subjects: Animals; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antiprotozoal Agents - therapeutic use; Case Report; Dysentery, Amebic - diagnosis; Dysentery, Amebic - etiology; Dysentery, Amebic - pathology; Fatal Outcome; Humans; Intestinal Perforation - etiology; Male; Metronidazole - therapeutic use; Middle Aged; Peritonitis - drug therapy; Peritonitis - etiology; Stomach Neoplasms - complications; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; 坏死性; 暴发性; 结肠炎; 腹膜炎; 鉴别诊断
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.3445

A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently, peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved. However, the patient＇s general condition worsened with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.