Multiple Colonic and Ileal Perforations due to Unsuspected Intestinal Amoebiasis – Case Report and Review

Publication date: Available online 19 August 2019Source: Pathology - Research and PracticeAuthor(s): Hui Wang, Rani KanthanAbstractAmoebiasis, caused by the intestinal protozoan Entamoeba histolytica, though a relatively common parasitic disease in the tropical and subtropical regions, is uncommon in the developed countries. In these countries, as amoebic colitis shares similar clinical symptoms and endoscopic features with inflammatory bowel disease (IBD), these cases can be easily unrecognized and misdiagnosed.In this case report, we discuss the case of an adult patient with invasive intestinal amoebiasis, who was initially managed as Crohn’s disease on corticosteroid treatment and subsequently rapidly deteriorated and developed multiple perforations in the colon and ileum. Despite total colectomy followed by resection of the small bowel, he died of multiple organ failure and sepsis within two months of his initial clinical presentation of diarrhea with abdominal pain.The learning point of this case is that invasive intestinal amoebiasis should be considered as a differential diagnosis at the first clinical adult presentation of IBD-like symptoms despite suggestive endoscopic findings of Crohn’s like ulcers. Regardless of negative endoscopic biopsies, due to the low sensitivity of microscopic examination, serology test for antibody and molecular test for Entamoeba DNA are recommended for accurate detection and identification of Entamoeba species, especially in the high ...
Source: Pathology Research and Practice - Category: Pathology Source Type: research