Invasive amoebiasis in two patients with AIDS and cytomegalovirus colitis

Abstract

Homosexual persons or human immunodeficiency virus (HIV)-infected patients frequently excrete cysts of nonpathogenic strains of Entamoeba histolytica ("Entamoeba dispar"). However, invasive amoebiasis is rare. We report two patients with AIDS and cytomegalovirus colitis in whom invasive amoebiasis was histologically diagnosed. It is concluded that E. histolytica has to be considered in HIV-infected patients with colitis.

Invasive amoebiasis: an emerging parasitic disease in patients infected with HIV in an area endemic for amoebic infection

“…Eleven other cases of HIV-infected patients with IA from whom detailed clinical history could be obtained have been described in the literature (Table 3) [10][11][12][13][14][15]. Combined with our 18 patients, the majority of the patients were homosexual or bisexual men and had AIDS although CD4+ lymphocyte counts were not known in most reported cases.…”

“…IA often co-existed with other enteric infections, with CMV colitis being the most common. Co-infection might also contribute to the clinical manifestations in these patients [10][11][12][13][14][15]. In the report by Fatkenheuer et al [15] two cases of concurrent amoebic colitis and CMV colitis were diagnosed and they were successfully treated only with metronidazole and ganciclovir [15].…”

“…Similarly, cases of IA are only rarely or never reported in HIV-infected patients, either from developed [10][11][12][13][14][15] or developing countries [16][17][18][19][20]. The reason remains unclear why IA is rare in HIV-infected patients despite their declining T-cell immunity, the major immunity against E. histolytica infection [2,21].…”

Invasive Amebiasis as an Emerging Parasitic Disease in Patients With Human Immunodeficiency Virus Type 1 Infection in Taiwan

“…Although the comparison groups were not perfectly matched to the HIV-infected persons, we believe that this is not a critical issue because the study was conducted in a single medical center in an endemic region for amebiasis. 23 There are only a few scattered case reports [16][17][18][19][20][21][22] of invasive amebiasis among HIV-infected persons in Western countries. Lowther and associates 11 conducted a large retrospective review of the medical diagnoses of more than 34 000 HIV-infected persons.…”

“…Investigators in Japan and Italy found a higher prevalence of antibody to E histolytica in homosexual men with or without HIV infection. [12][13][14][15] Case reports [16][17][18][19][20][21][22] from various countries describe invasive amebiasis in homosexual men with or without HIV infection. Recent reports from Taiwan 23 and Korea 24 describe cases of invasive amebiasis in homosexual men.…”