Learning points from a case of severe amoebic colitis

Infez Med. 2017 Sep 1;25(3):281-284.

Abstract

A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who had been given the incorrect diagnosis of ulcerative colitis. His symptoms were so severe that a colectomy was being considered. The patient had a significant travel history including trips to Morocco, the Gambia and Cape Verde, putting him at risk of acquiring amoebic disease. However, this history was not ascertained until much later on in the disease process. The case highlighted crucial learning points including the importance of taking a lifelong travel history, the difficulties in telling ulcerative colitis and amoebic colitis apart both clinically and histopathologically, and the importance of sending multiple stool samples for parasitological microscopy analysis in patients being investigated for inflammatory bowel disease.

Publication types

  • Case Reports

MeSH terms

  • Colitis, Ulcerative / diagnosis*
  • Combined Modality Therapy
  • Delayed Diagnosis
  • Diagnosis, Differential
  • Diagnostic Errors*
  • Drainage
  • Dysentery, Amebic / diagnosis*
  • Dysentery, Amebic / drug therapy
  • Dysentery, Amebic / parasitology
  • Dysentery, Amebic / pathology
  • Entamoeba histolytica / isolation & purification
  • Entamoebiasis / diagnosis*
  • Entamoebiasis / drug therapy
  • Entamoebiasis / parasitology
  • Entamoebiasis / surgery
  • Feces / parasitology
  • Humans
  • Liver Abscess, Amebic / diagnosis*
  • Liver Abscess, Amebic / drug therapy
  • Liver Abscess, Amebic / surgery
  • Male
  • Medical History Taking
  • Metronidazole / therapeutic use
  • Middle Aged
  • Parenteral Nutrition, Total
  • Paromomycin / therapeutic use
  • Travel-Related Illness

Substances

  • Metronidazole
  • Paromomycin