Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis most commonly reported among patients undergoing chemotherapy for acute myeologenous leukemia (AML). Its clinical findings are non-specific, usually seen as erythematous papules, nodules and plaques on the extremeties, trunk and face. Here, we are presented with a 51-year-old male with one-week history of atypical annular plaques on the extremities. Based on bone marrow biopsy, a diagnosis of acute myelogenous leukemia was established. The presence of diarrhea prior to skin findings was attributed to typhoid fever, giardiasis and amoebiasis for which  antibiotics were given. Skin biopsy showed aggregates of neutrophils around eccrine glands, consistent with NEH. Spontaneous resolution was  noted after 3 weeks. To our knowledge, there are only five other reported cases on NEH heralding the onset of a malignancy and unassociated with chemotherapeutic drug intake. In this scenario, the following culprits are suspected: as a reactive manifestation from antibiotic intake, as a part and parcel of an infectious process or a paraneoplastic phenomenon from acute myelogenous leukemia.

Human ; Male ; Middle Aged ; Amebiasis ; Anti-bacterial Agents ; Biopsy ; Bone Marrow ; Diarrhea ; Dysentery, Amebic ; Eccrine Glands ; Giardiasis ; Hidradenitis ; Leukemia, Myeloid, Acute ; Neutrophils ; Typhoid Fever

Some cases have reported that amebic colitis leads to serious complications that are caused by a misdiagnosis of an inflammatory bowel disease and consequential ill-managed steroid therapy. Therefore, it should be stressed that the differential diagnosis on such a case is very important. Eosinophilic colitis may reveal its presence as diarrhea, abdominal pain, ascites, and eosinophilic deposits in tissues. Therefore, it is highly necessary to make a differential diagnosis to distinguish eosinophilic colitis from other infectious or inflammatory bowel diseases. We report a case of amebic colitis, which was mistakenly diagnosed as eosinophilic colitis and a liver eosinophilic abscess in a young male who complained of bloody diarrhea and right upper quadrant pain. However, the misdiagnosed steroid therapy did not aggravate the progress of the amebic infection.
Abdominal Pain ; Abscess ; Amoeba ; Ascites ; Colitis ; Diagnosis, Differential ; Diagnostic Errors ; Diarrhea ; Dysentery, Amebic ; Eosinophils ; Humans ; Inflammatory Bowel Diseases ; Liver ; Liver Abscess ; Male ; Steroids

No abstract available.
Dysentery, Amebic ; Enterocolitis, Pseudomembranous ; Sigmoidoscopy

This is a case series of 123 patients with Hirschsprung's disease who were surgically treated with a one-stage transanal endorectal pullthrough by this author and his team in 5 medical institutions in the Philippines. It describes the surgical procedure done and its surgical outcome. Seventy-six patients were 24 months old and younger, 47 were mostly 3 years old and above. Presumptive diagnosis was based on clinical and radiologic evidence, and confirmatory diagnosis on intra-operative frozen section biopsy and postoperative paraffin section. Meticulous attention was given to preoperative colonic saline washout, and intraoperatively to adequate mesenteric vessel ligation and complete aganglionic colectomy with a generous normoganglionic segment. The mean length of bowel resected was 13.9 cm (8.5cm to 32cm), and average operative time, exclusive of the rectal irrigation and frozen section, was 120 minutes (80 to 210 minutes). Surgical morbidity was noted in 16 percent of patients (4 wound infections, 5 bleeding, 1 twisted anastomosis, 8 concentric rings, and 2 posterior wall edema). Medical morbidity was 7% (2 febrile episodes from protracted amoebiasis, 5 non-specific enterocolitis, 1 gastric bleeding, and 1 gastric distention). Normal bowel movement was achieved within 3 months by 97 patients (79%), within 6 months by 24 patients (19%), and more than a year in 2 patients (2%). There was no incidence of recurrent constipation. Children with soiling responded to toilet training. There was no mortality.

Human ; Frozen Sections ; Paraffin ; Constipation ; Operative Time ; Toilet Training ; Hirschsprung Disease ; Dysentery, Amebic ; Enterocolitis ; Amebiasis ; Colectomy ; Edema ; Attention ; Wound Infection

Intestinal amoebiasis is caused by the protozoan Entamoeba histolytica. Amoebic colitis is usually acquired by ingesting contaminated food or water, but it can be associated with cell-mediated immunosuppression in organ-transplant recipients. We present a case of invasive amoebic colitis in a kidney-transplant recipient who was treated successfully with metronidazole and adjusted immunosuppressive therapy. The patient was a 49-year-old man who had undergone renal transplantation 15 years earlier. He complained of diarrhea accompanied by mild lower abdominal pain over five weeks, and the diagnosis of amoebic colitis was made with a colonoscopic biopsy. The colonoscopic findings showed multiple, round, scattered ulcerations throughout the colon, and trophozoites of E. histolytica were identified in the base of these ulcers. We treated his colitis with metronidazole and a reduction in immunosuppressive therapy.
Abdominal Pain ; Biopsy ; Colitis ; Colon ; Diarrhea ; Dysentery, Amebic ; Entamoeba histolytica ; Humans ; Immunosuppression ; Kidney Transplantation ; Metronidazole ; Middle Aged ; Trophozoites ; Ulcer

PURPOSE: Nowadays, with improvements in hygiene and in the sewage system, the prevalence of amebic colitis in Korea is declining. However, amebic colitis still occurs every year. We investigated the clinical features of current patients with amebic colitis and compared the results with those for a past endemic period in Korea. METHODS: From June 2000 to June 2005, 10 patients were diagnosed in the Digestive endoscopy center of Song Do colorectal hospital as having amebic colitis. We evaluated their medical histories, clinical characteristics, and colonoscopic findings. RESULTS: The male-to-female ratio was 1.5 : 1. The mean age was 38.4+/-11.4 years. The mean diagnostic period from occurrence of symptoms to diagnosis was 20.4+/-17.5 days. The clinical symptoms of amebic colitis were diarrhea (80%), bloody stool (70%), mucoid stool (60%), abdominal pain (50%), fever, weight loss, nausea, and fatigue. Seven patients (70%) had a history of travel, and six of those seven patients had taken trips abroad. The foreign areas of travel included India (50%), Indonesia (28.6%), and Japan (16.7%). The diagnostic methods were colonoscopic biopsies to detect trophozoites of Entameba histolytica (90%) and serologic tests for the anti-ameba antibody (10%). The most common colonic locations of the lesions were the cecum (80%) and the rectum (80%). Another was the ascending colon (30%); pan-colonic involvement was also seen (10%). CONCLUSIONS: In the past, the cause of amebic colitis in Korea was poor hygiene. Nowadays, however, travel to amebiasis-endemic areas may be the most important cause. Therefore, the travel history of diarrheal patients is an important diagnostic factor in cases of amebic colitis and a differential diagnosis factor in cases of inflammatory bowel disease.
Abdominal Pain ; Biopsy ; Cecum ; Colon ; Colon, Ascending ; Diagnosis ; Diagnosis, Differential ; Diarrhea ; Dysentery, Amebic* ; Endoscopy ; Fatigue ; Fever ; Humans ; Hygiene ; India ; Indonesia ; Inflammatory Bowel Diseases ; Japan ; Korea ; Music ; Nausea ; Prevalence ; Rectum ; Serologic Tests ; Sewage ; Trophozoites ; Weight Loss

An acute fulminant amoebic colits rarely develops as a complication of amoebiasis, and is difficult to diagnose and treat when it occurs. It is a life-threatening disease, and associated with a very high mortality rate. Herein, a case 42-old-year man, who had a generalized peritonitis caused by an acute fulminant amoebic colitis, is reported, with a review of the literature. He died of multiple organ failure, following sepsis and disseminated intravascular coagulation, on the 19th day after his operation, despite treatment with aggressive surgery and anti-amoebic agents. An emergency laparotomy should be considered when an acute fulminant amoebic colitis deteriorates despite the use of intensive anti-amoebic therapy, especially when there is an acute episode suggestive of perforation. A primary total resection of the diseased colon is one of the treatments of choice.
Amebiasis ; Colon ; Disseminated Intravascular Coagulation ; Dysentery, Amebic* ; Emergencies ; Laparotomy ; Mortality ; Multiple Organ Failure ; Peritonitis* ; Sepsis

No abstract availble
Biopsy ; Colonoscopy ; Dysentery, Amebic/complications/*diagnosis/pathology ; Edema/*complications ; Humans ; Male ; Middle Aged

The hemolytic uremic syndrome(HUS), a heterogenous group of disorders characterized by micorangiopathic hemolytic anemia, thrombocytopenia, and azotemia, is the most frequent cause of acute renal failure in children. The association of the HUS with E. coli O157:H7 has been well-described, but the other intestinal infection have been relatively less reported to date. We report a 18-month-old boy presenting with typical clinical characteristics of HUS associated with amoebic dysentery with a brief review of literatures.
Acute Kidney Injury ; Anemia, Hemolytic ; Azotemia ; Child ; Dysentery, Amebic* ; Hemolytic-Uremic Syndrome* ; Humans ; Infant ; Male ; Thrombocytopenia

PURPOSES: In May 29, 1999, the health department in Gumi city received a report from a local pediatrician that three children who attended a kindergarten were diagnosed with amebic dysentery. By May 31, fifteen more children from the same kindergarten were diagnosed with amebic dysentery. We conducted an investigation in order to verify the diagnosis, and to implement appropriate control measures. METHODS: We conducted a questionnaire survey on 264 children in 3 kindergarten in Gumi city. Furthermore, 726 children in 4 kindergarten and 13 academies in Chilgok county whose lunch is supplied by the same unlicensed catering company were monitored for diarrheal symptoms. RESULTS: Of 264 children in Gumi city, 74 children fitted the case definition (attack rate, 28%). Of 726 children in Chilgok county, 50 children were reported to have diarrheal symptoms. The clinical picture was dominated by the following symptoms; abdominal pain (85.1%), fever (83.8%), headache (50.0%), chilling (45.9%), vomiting (28.4%). The median duration of diarrhea was 2 days, and the median frequency of diarrhea was 3 times/day. Salmonella Typhimurium of the same antibiogram pattern were isolated from fifteen cases. However, no evidence of amebiasis was found from laboratory results or epidemiologic pattern. CONCLUSIONS : This epidemic was caused by Salmonella Typhimurium, which were present in lunch supplied by the unlicensed catering company. Improvement of the diagnostic ability in local health centers as well as public health centers and reinforcement of strict protocols regarding appropriate management of catering services should be emphasized
Abdominal Pain ; Academies and Institutes ; Amebiasis* ; Child ; Diagnosis ; Diarrhea ; Disease Outbreaks ; Dysentery, Amebic ; Fever ; Gyeongsangbuk-do* ; Headache ; Humans ; Korea* ; Lunch ; Microbial Sensitivity Tests ; Public Health ; Salmonella Infections* ; Salmonella typhimurium ; Vomiting ; Surveys and Questionnaires