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

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

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

A patient with a fulminant amebic colitis coexisting with intestinal tuberculosis had a sudden onset of crampy abdominal pain, mucoid diarrhea, anorexia, fever and vomiting with signs of positive peritoneal irritation. Fulminant amebic colitis occurring together with intestinal tuberculosis is an uncommon event and may present an interesting patho-etiological relationship. The diagnosis was proven by histopathologic examination of resected specimen. Subtotal colectomy including segmental resection of ileum, about 80 cm in length, followed by exteriorization of both ends, was performed in an emergency basis. Despite all measures, the patient died on the sixth postoperative day. The exact relationship of fulminant amebic colitis and intestinal tuberculosis is speculative but the possibility of a cause and effect relationship exists. Fulminant amebic colitis may readily be confused with other types of inflammatory bowel disease, such as idiopathic ulcerative colitis, Crohn's disease, perforated diverticulitis and appendicitis with perforation. This report draws attention to the resurgence of tuberculosis and amebiasis in Korea, and the need for the high degree of caution required to detect it.
Journal Article ; Diagnosis, Differential ; Dysentery, Amebic/surgery ; Dysentery, Amebic/pathology* ; Dysentery, Amebic/diagnosis ; Dysentery, Amebic/complications ; Fatal Outcome ; Human ; Male ; Middle Age ; Tuberculosis, Gastrointestinal/surgery ; Tuberculosis, Gastrointestinal/pathology ; Tuberculosis, Gastrointestinal/complications*