Intestinal amoebiasis
Infection with E. histolytica may be asymptomatic or may cause dysentery or extra intestinal disease . Asymptomatic infection should be treated because of its potential to progress to invasive disease. Patients with amebic colitis typically present with a several-week history of cramping abdominal pain, weight loss, and watery or bloody diarrhea.
The insidious onset and variable signs and symptoms make diagnosis difficult, with fever and grossly bloody stool absent in most cases.
The differential diagnosis of a diarrheal illness with occult or grossly bloody stools should include infection with shigella, salmonella, campylobacter, and enteroinvasiveand enterohemorrhagic
Escherichia coli.
Noninfectious causes include inflammatory bowel disease, ischemic colitis, diverticulitis, and arteriovenous malformation.
Unusual manifestations of amoebic colitis include acute necrotizing colitis, toxic mega colon, ameboma and perianal ulceration with potential formation of a fistula. Acute necrotizing colitis is
rare (occurring in less than 0.5 percent of cases) and is associated with a mortality rate of more than 40 percent.
Patients with acute necrotizing colitis typically appear very ill, with fever, bloody mucoid
diarrhea, abdominal pain with rebound tenderness, and signs of peritoneal irritation. Surgical intervention is indicated if there is bowel perforation or if the patient has no response to antiamebic therapy.
Toxic megacolon is rare (occurring in approximately 0.5 percent of cases) and is typically associated with the use of corticosteroids. Early recognition and surgical intervention are important, since patients with toxic megacolon usually have no response to antiamebic therapy alone. Ameboma results from the formation of annular colonic granulation tissue
at a single site or multiple sites, usually in the cecum or ascending colon. An ameboma may mimic carcinoma of the colon.
The insidious onset and variable signs and symptoms make diagnosis difficult, with fever and grossly bloody stool absent in most cases.
The differential diagnosis of a diarrheal illness with occult or grossly bloody stools should include infection with shigella, salmonella, campylobacter, and enteroinvasiveand enterohemorrhagic
Escherichia coli.
Noninfectious causes include inflammatory bowel disease, ischemic colitis, diverticulitis, and arteriovenous malformation.
Unusual manifestations of amoebic colitis include acute necrotizing colitis, toxic mega colon, ameboma and perianal ulceration with potential formation of a fistula. Acute necrotizing colitis is
rare (occurring in less than 0.5 percent of cases) and is associated with a mortality rate of more than 40 percent.
Patients with acute necrotizing colitis typically appear very ill, with fever, bloody mucoid
diarrhea, abdominal pain with rebound tenderness, and signs of peritoneal irritation. Surgical intervention is indicated if there is bowel perforation or if the patient has no response to antiamebic therapy.
Toxic megacolon is rare (occurring in approximately 0.5 percent of cases) and is typically associated with the use of corticosteroids. Early recognition and surgical intervention are important, since patients with toxic megacolon usually have no response to antiamebic therapy alone. Ameboma results from the formation of annular colonic granulation tissue
at a single site or multiple sites, usually in the cecum or ascending colon. An ameboma may mimic carcinoma of the colon.
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