1/10. Toxic amebic colitis coexisting with intestinal tuberculosis.A patient with a fulminant amebic colitis coexisting with intestinal tuberculosis had a sudden onset of crampy abdominal pain, mucoid diarrhea, anorexia, fever and vomiting with signs of positive peritoneal irritation. Fulminant amebic colitis occurring together with intestinal tuberculosis is an uncommon event and may present an interesting patho-etiological relationship. The diagnosis was proven by histopathologic examination of resected specimen. Subtotal colectomy including segmental resection of ileum, about 80 cm in length, followed by exteriorization of both ends, was performed in an emergency basis. Despite all measures, the patient died on the sixth postoperative day. The exact relationship of fulminant amebic colitis and intestinal tuberculosis is speculative but the possibility of a cause and effect relationship exists. Fulminant amebic colitis may readily be confused with other types of inflammatory bowel disease, such as idiopathic ulcerative colitis, Crohn's disease, perforated diverticulitis and appendicitis with perforation. This report draws attention to the resurgence of tuberculosis and amebiasis in korea, and the need for the high degree of caution required to detect it.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
2/10. Necrotizing amebic colitis in a child.Necrotizing amebic colitis (NAC) is a rare complication of intestinal amebiasis, and only a few cases have been reported in the literature. The outcome of NAC is dismal, particularly in children. We encountered a 3-year-old child who presented with bloody diarrhea, fever, toxemia, and peritonitis. At laparotomy the whole colon was found to be necrotic with several perforations. Histopathology of the resected colon showed features of NAC. This is a rare case of survival of a child with NAC involving the whole colon.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
3/10. Endoscopic view of rectal amebiasis mimicking a carcinoma.We report the case of a 45-year-old man with rectal amebiasis, presenting with rectal bleeding and chronic diarrhea, confirmed on rectal biopsy. The endoscopic view was highly suggestive of a carcinoma and caused confusion about its etiology. The striking difference in the endoscopic view before and after medical therapy of the tumor-like lesion was remarkable. This case illustrates the importance of an accurate histologic diagnosis before definitive treatment and highlights the mimicry of rectal carcinoma by rectal amebiasis on endoscopy.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
4/10. Massive trichuris trichiura infection as a cause of chronic bloody diarrhea in a child.The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.- - - - - - - - - - ranking = 6keywords = diarrhea (Clic here for more details about this article) |
5/10. Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis.Invasive amoebiasis is rarely seen in human immunodeficiency virus (hiv)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old hiv-infected man with amoeba colitis, disseminated mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
6/10. amebiasis presenting as rectal bleeding without diarrhea in childhood.A 6-year-old boy with no history of foreign travel had presented with rectal bleeding without diarrhea for 2 months. Despite negative stool cultures, a diagnosis of intestinal amebiasis was made by colonoscopy with tissue biopsy. In cases of persistent rectal bleeding, even without diarrhea, a diagnosis of amebiasis should be considered. When routine stool parasite examinations are negative, unsuspected amebiasis may be diagnosed by sigmoidoscopy or colonoscopy with tissue biopsy.- - - - - - - - - - ranking = 6keywords = diarrhea (Clic here for more details about this article) |
7/10. exercise-induced diarrhea: when to wonder.exercise-associated lower gastrointestinal symptoms seem to be a fairly common clinical finding occurring in anywhere from 10-50% of runners. However, it is unclear what percentage of those affected may have discrete medical conditions that are exacerbated by strenuous physical exertion. Perhaps, difficult physical training sessions function as a "stress test" for the colon. A case report of exercise induced diarrhea is presented with a discussion of the current medical literature and proposed management for the primary care sports physician.- - - - - - - - - - ranking = 5keywords = diarrhea (Clic here for more details about this article) |
8/10. Symptomatic amebic colitis in a Japanese homosexual AIDS patient.A 30-year-old Japanese homosexual AIDS patient was admitted to hospital because of Kaposi's sarcoma and mild diarrhea on February 4, 1993. Mud-like stool with blood and mucous was recognized after admission. Although serologic tests for entamoeba histolytica were negative, trophozoites of E. histolytica were identified in his bloody stool. Daily doses of 1,000 mg of metronidazole were given orally for 6 days and then 750 mg for 4 days, and good results were observed. His CD4 count was 19.5/mm3. Symptomatic amebic colitis was easily treated and good results were obtained even with the extremely diminished CD4 count. This is the first published report of symptomatic amebic colitis in an AIDS patient in japan.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
9/10. amebiasis after bone marrow transplantation.A patient undergoing BMT for acute non-lymphocytic leukemia (ANLL) developed bloody diarrhea due to amebiasis. The infection was successfully treated with intensive and prolonged antiparasitic therapy.- - - - - - - - - - ranking = 1keywords = diarrhea (Clic here for more details about this article) |
10/10. Persistent diarrhea caused by isospora belli: therapeutic response to pyrimethamine and sulfadiazine.A 54-year-old human immunodeficiency virus (hiv)-positive homosexual man developed overwhelming watery diarrhea and marked weight loss over a 3-week period. Although entamoeba histolytica and other nonpathogenic enteric protozoa were observed along with isospora belli in this patient's stool specimens, they were promptly eradicated after metronidazole (flagyl) treatment. The presence of I. belli oocysts in various stages of development in the stool and clinical symptoms related to isospora infection persisted for 10 more months despite treatment with combined chemotherapeutic agents. Clinical and parasitiological resolution was ultimately achieved through an 8-week course of pyrimethamine and sulfadiazine.- - - - - - - - - - ranking = 5keywords = diarrhea (Clic here for more details about this article) |
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