Cases reported "Dysentery, Amebic"

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1/74. US and CT findings of rectal amebian abscess.

    An interesting case of rectal amebic abscess is presented. Ultrasound and CT images provided the diagnosis of a cystic intramural mass at the rectal wall of a young man, who complained of pelvic pain, constipation, and fever. His clinical history of amebiasis and the finding of trophozoids and cysts at the stool swap confirmed the diagnosis. Intravenous metronidazole therapy cured the disease and led to total disappearance of the mass, and clinical well-being. ( info)

2/74. Asymptomatic amebic colitis in a homosexual man.

    We describe case of a 75-yr-old Japanese homosexual man who was diagnosed as having amebic colitis. The present case is unique in that invasive amebiasis has occurred in a homosexual man, because entamoeba histolytica in homosexual patients is considered to be a nonpathogenic and commensal organism in western countries, and that the patient has not complained of any gastrointestinal symptoms associated with minute colonic lesion of an isolated cecal ulcer. This report indicates that the absence of gastrointestinal symptoms does not rule out invasive amebiasis. Therefore, once the ameba is identified in stool specimens, even in homosexual men, it is important to differentiate pathogenic from nonpathogenic species irrespective of whether the patient is symptomatic, and to treat the patient infected with pathogenic species. By means of this strategy, we can prevent pathogenic ameba from spreading in the community. ( info)

3/74. Amebic colitis mistaken for inflammatory bowel disease.

    In ten patients, amebic colitis was mistakenly diagnosed as ulcerative colitis or crohn disease of the colon because of the similarity of history, physical examination, and routine laboratory studies as well as findings on proctoscopic and barium enema examination. Multiple stool examinations failed to demonstrate ova or trophozoites of entamoeba histolytica. Routine examinations of stools for ova and parasites are inadequate and even a meticulous search for amebas in fresh stool, in scrapings from bowel ulcer, or in biopsy material may give negative results. The indirect hemagglutination test was shown to be a reliable diagnostic test in the evaluation of these cases. Because corticosteroid treatment of patients with amebic colitis may lead to undesirable complications the indirect hemagglutination test results should be obtained in patients in whom such diagnostic confusion is likely. ( info)

4/74. Transient appendiceal enlargement in a patient with colonic amebiasis: sonographic detection and follow-up.

    A case of colonic amebiasis with no clinical signs of acute appendicitis but with sonographic visualization of an enlarged appendix is reported. As antiamebic therapy resolved the clinical signs and symptoms of the amebiasis, the sonographic appearance of the appendix returned to normal. Thus, an enlarged appendix does not necessarily indicate clinical appendicitis in patients with colonic amebiasis. ( info)

5/74. Colonic perforation in unsuspected amebic colitis.

    Unsuspected amebic colitis presenting as inflammatory bowel disease, as in our patient, has been previously reported (4, 7, 8). Misdiagnosis, delay in antibiotic treatment, and institution of immunosuppression were the result of failure to identify the parasite in stool specimens and have resulted in suffering, morbidity, mortality, and surgery. In all previously reported cases, routine stool studies failed to identify E. histolytica (4, 7, 8). The correct diagnosis was only established after reviewing the surgical specimen or biopsies obtained endoscopically. Because the erroneous diagnosis of inflammatory bowel disease can lead to disastrous complications, it is imperative to exclude amebic colitis prior to undertaking steroid therapy, especially in patients with a prior history of travel to or residence in areas with endemic E. histolytica (17). We recommend obtaining at least three stool specimens for microscopic examination, as well as testing for serum amebic antibody. patients should submit fresh stool specimens directly to the laboratory to allow for prompt diagnostic evaluation. Such an approach might lead to the improved diagnosis of amebiasis. ( info)

6/74. Acute appendicitis caused by amebiasis.

    We report a case of appendicitis caused by amebiasis in a 45-year-old Japanese man. He presented to our hospital with bloody stools in June 1998. sigmoidoscopy disclosed erosion, and a biopsy of the erosion showed colitis caused by entamoeba histolytica infection. Four months later, he was admitted to our hospital with a small elastic mass and severe pain in the lower quadrant of the abdomen, which was diagnosed as acute appendicitis. He underwent appendectomy. Histopathological examination revealed numerous E. histolytica trophozoites, and we diagnosed acute appendicitis caused by E. histolytica. The patient has been free of symptoms, colonoscopy has revealed no erosion, and biopsy has revealed no E. histolytica for 12 months after the operation. ( info)

7/74. 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. ( info)

8/74. Ruptured liver abscess with fulminant amoebic colitis: case report with review.

    Amoebic liver abscess is the commonest extra intestinal manifestation of amoebiasis. Intraperitoneal rupture of liver abscess and fulminant necrotizing amoebic colitis are rare occurrences which complicate a severe form of invasive disease caused by entamoeba histolytica. These complications are associated with a high morbidity and mortality. Synchronous pathological lesions in colon and liver are rare. Still rare is the occurrence of complicated colonic and hepatic invasive amoebiasis presenting as an acute abdomen. One such presentation of ruptured liver abscess and necrotizing amoebic colitis in a 70 year old male which was successfully managed is being reported. ( info)

9/74. Amoeboma of ascending colon with multiple amoebic liver abscesses.

    A case of amoeboma of the ascending colon with multiple amoebic liver abscess is being presented; which was mistakenly diagnosed as carcinoma of ascending colon with multiple secondaries in liver. awareness of this previously unreported association is important because it adds to our knowledge of the spectrum of intestinal amoebiasis. ( info)

10/74. Amebic liver abscess and human immunodeficiency virus infection: a report of three cases.

    Invasive amebiasis rarely occurs in homosexual men and human immunodeficiency virus (hiv)-infected individuals and has not been regarded as a beacon for concomitant hiv infection. We encountered a bisexual man with a protracted course of amebic liver abscess and amebic colitis. In the presence of fever, generalized lymphadenopathy, and elevated serum aminotransferase levels, hiv infection was suspected and then confirmed by a de novo seroconversion of hiv antibody. Subsequently, we noted two consecutive patients with amebic liver abscess, also later found to be infected with hiv. The ameba obtained from these three cases was identified as entamoeba histolytica by amplification of 16S ribosomal rna by polymerase chain reaction and direct sequencing. This observation suggests that amebic liver abscess and colitis can be presentations for hiv infection in the far east. Thus, the local patients with invasive amebiasis, especially those with a protracted course or with risk factors of hiv infection, should be tested for hiv. ( info)
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