Fulminant Amebic Colitis in an HIV-infected Homosexual Man

Abstract

We present a case of fulminant amebic colitis in a human immunodeficiency virus (HIV)-infected homosexual man. The patient developed colonic perforation over a short time despite empirical therapy with metronidazole, and underwent right hemicolectomy. Amebic colitis was pathologically diagnosed by identifying invasive trophozoites of Entamoeba in a surgical specimen. Amebic colitis is one of the important differential diagnoses of acute abdomen in HIV-infected patients and/or homosexual men, especially in East Asia. Although fulminant amebic colitis is a rare manifestation of amebiasis, early diagnosis and treatment are thought to be important to improve the outcome of this highly fatal complication.

Toxic Megacolon due to Fulminant Amebic Colitis in a non Endemic Area

“…Risk factors for invasive disease include the virulence of the strain of E. histolytica, as well as host factors including genetic susceptibility, young age, pregnancy and impaired immunity (for example. due to treatment with corticosteroids, malignancy, malnutrition, alcoholism, and HIV infection) [4][5][6]. The patient under discussion developed fulminant colitis within a non endemic region, a feature which has only been rarely reported in the absence of recent travelling [7].…”