Fatal intestinal amoebiasis

Thuse, M G

doi:10.1136/pgmj.55.646.548

Cited by 6 publications

(2 citation statements)

References 14 publications

(17 reference statements)

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“…Peritonitis may develop either because of frank perforation due to transmural inflammation or necrosis leading to leaking through an extensively necrosed bowel [ 14 ]. Immunosuppression favours invasion of amoeba through the gut wall forming typical flask-shaped ulcers [ 15 ]. FulNAC is an uncommon complication, arduous to diagnose and treatment, and associated with a high mortality rate, ranging from 55% to 100% [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Fulminant Necrotising Amoebic Colitis of Whole of Large Bowel: A Rare Complication of a Common Infectious Disease

Beg

Bains

Mahajan

et al. 2020

Case Reports in Infectious Diseases

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Background. Fulminant necrotising amoebic colitis (FulNAC) is an uncommon and grave complication of a very common infectious disease widely prevalent in tropical countries. In most of the cases reported, only a segment of large bowel was gangrenous. The involvement of the whole of the large bowel, as in our case, is very rare and has very high mortality ranging from 55% to 100%. Case Summary. A 50-year-old gentleman presented with an acute abdomen with a history of crampy abdominal pain and passage of blood mixed with mucous and loose stools. After resuscitation and investigations, the patient was taken up for laparotomy and the findings showed that the caecum was sloughed off and the entire large bowel had multiple perforations. Subtotal colectomy with ileostomy was performed. Histopathological examination showed evidence of pancolitis with multiple colonies of amoebic trophozoites. Discussion. Entamoeba histolytica is a protozoon that affects the large intestine and liver in humans. There can be various presentations of amoebiasis: asymptomatic infection (90%), symptomatic noninvasive infection (6–8%), acute amoebic colitis (dysentery), or fulminant colitis with perforation. FulNAC is an uncommon complication, difficult to diagnose and treat, and associated with a high mortality rate, ranging from 55% to 100%. Conclusion. It is important to consider the possibility of fulminant necrotising amoebic colitis (FulNAC) as an uncommon and fatal complication of amoebiasis, especially in tropical countries, where amoebiasis is prevalent. Early diagnosis and antiamoebic treatment, along with urgent aggressive surgical resection of the involved segment and exteriorization of the proximal and distal bowel ends, are shown to reduce mortality.

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Section: Discussionmentioning

confidence: 99%

Fulminant Necrotising Amoebic Colitis of Whole of Large Bowel: A Rare Complication of a Common Infectious Disease

Beg

Bains

Mahajan

et al. 2020

Case Reports in Infectious Diseases

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“…30 Additional studies in the literature support a mortality rate of 50% to 100% (Table 1). 1,[30][31][32][33][34][35][36][37][38] Finally, fulminating colitis has been observed with increasing frequency in patients suffering from malnutrition, diabetes, and other chronic illnesses. 31 The classic operative finding in a patient with fulminating colitis is an inflamed, extremely friable colon.…”

Section: Amebiasismentioning

confidence: 99%

Amebiasis

Alavi

2007

Clinics in Colon and Rectal Surgery

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Amebiasis is an important cause of death from parasitic disease worldwide. The causative organism is Entamoeba histolytica, which has an infective cyst stage and a pathogenic and motile trophozoite stage. The clinical presentation can vary from an asymptomatic carrier state to fulminant colitis and colonic perforation. The majority of patients can be managed medically. However, a small percentage of patients require urgent exploration and resection with an associated high mortality rate. Early recognition and initiation of medical therapy including treatment of asymptomatic carriers are vital to preventing catastrophic outcomes.

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