A Case of Fulminant Amoebic Colitis with Total Colon Necrosis

Abstract

A 72-year-old man complaining of diarrhea, fever, and abdominal pain visited a previous hospital and was hospitalized with a diagnosis of infectious enteritis. Despite medication, his symptoms did not improve and he was admitted to our hospital. CT showed extensive necrosis of the colon and an emergency operation was performed. Necrosis was observed throughout the ascending colon, transverse colon and sigmoid colon, and was partially lytic. Total colectomy and ileostomy were performed, and the patient was treated in the intensive care unit after surgery. On postoperative day 5, amoeboid bodies were detected in the pathological specimen, leading to diagnosis of fulminant amoebic colitis. Metronidazole was started, but the patient died on the same day due to acute liver failure and progression of acidemia. This case indicates that in a case of enteritis that is difficult to diagnose, it is important to start treatment as soon as possible after a thorough examination with this disease in mind.