Acute fulminant necrotizing amoebic colitis: a rare and fatal complication of amoebiasis: a case report

Abstract

Acute Fulminant Necrotizing Amoebic Colitis is a rare complication of amoebiasis that is associated with high mortality. Only one to four such cases are seen per year in large hospitals of India, and only few such cases have been reported in the literature. The condition requires early diagnosis and surgical intervention. We recently cared for a patient who presented with acute abdomen with history of intermittent abdominal pain and diarrhea. Before presenting to our institution he was misdiagnosed as a case of inflammatory bowel disease and had been treated with steroids. On emergency exploration, extensive necrosis and multiple perforations in retroperitoneum involving entire colon were seen. Total colectomy with ileostomy was performed. Postoperative course was marked by septicaemia and multi-organ failure followed by death. This case report emphasizes the importance of early diagnosis and treatment of acute FAC, and associated high mortality.

Molecular Detection of the Carriage Rate of Four Intestinal Protozoa with Real-Time Polymerase Chain Reaction: Possible Overdiagnosis of Entamoeba histolytica in Nigeria

“…For instance, overdiagnosis of E. histolytica implies that colitis resulting from bacterial agents such as Campylobacter and Shigella species will probably be inappropriately treated with antiprotozoal drugs, while failure to specifically diagnose E. histolytica is associated with fatal consequences. 30,31 There are still large gaps in the knowledge of species prevalence rates in different regions of the world, particularly in the African continent where very few studies are being performed using molecular methods. To address this deficit, there is a need to implement species-specific diagnosis of E. histolytica.…”

Amoebic Colonic Perforation Presenting as Peritonitis in Emergency, Incidence and Outcome: Our Experience

“…In our study, associated liver abscess was seen in 36% cases, emphasing its coexistence, and it was noticed that these patients were more sick and developed more postoperative complications compared to those who presented only amoebic colonic perforation. Most common perforation was seen in caecum, with a good num- ber of patients having multiple perforations involving caecum and ascending colon, which differed from the available studies, where ascending colon appeared to be the most common site (1,2,4).…”

“…E. histolytica infections, which cause amoebiasis, begin with ingestion of water contami nated with fecal matter containing cysts of the amoeba (1). Trophozoites of the amoeba are released into the lumen of the gastrointestinal tract, where they rapidly clone themselves and further form new cysts, which are excreted in the faeces (2). The infection can be located in any part of the intestine, but is most likely to be found in the caecum and ascending colon, as seen in our case (3).…”

A rare and potentially fatal complication of amoebiasis: acute fulminant necrotizing amoebic colitis

“…Conventional microscopic examination of stool has a low sensitivity (25%) [2,4]. Antigen detection in the patient's stool and serum is the most sensitive and specific investigation [2,5].…”

“…Antigen detection in the patient's stool and serum is the most sensitive and specific investigation [2,5]. CT is the imaging of choice for diagnosis and assessment for complications of amoebic colitis [4].…”