CASE REPORT: Colonic perforation in unsuspected amebic colitis

Maher A. Abbas, David C. Mulligan, Nizar N. Ramzan, Janis E. Blair, Jerry D. Smilack, Michael S. Shapiro, Thomas K. Lidner, Kevin W. Olden

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article number228660
Pages (from-to)1836-1841
Number of pages6
JournalDigestive Diseases and Sciences
Volume45
Issue number9
DOIs
StatePublished - Jan 1 2000

Keywords

  • Amebic colitis
  • Inflammatory bowel disease
  • Intestinal perforation

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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    Abbas, M. A., Mulligan, D. C., Ramzan, N. N., Blair, J. E., Smilack, J. D., Shapiro, M. S., Lidner, T. K., & Olden, K. W. (2000). CASE REPORT: Colonic perforation in unsuspected amebic colitis. Digestive Diseases and Sciences, 45(9), 1836-1841. [228660]. https://doi.org/10.1023/A:1005561607130