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Colonic perforation in unsuspected amebic colitis.
Dig Dis Sci. 2000 Sep; 45(9):1836-41.DD

Abstract

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.

Authors+Show Affiliations

Department of Surgery, Mayo Clinic Scottsdale, Arizona 85259, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11052328

Citation

Abbas, M A., et al. "Colonic Perforation in Unsuspected Amebic Colitis." Digestive Diseases and Sciences, vol. 45, no. 9, 2000, pp. 1836-41.
Abbas MA, Mulligan DC, Ramzan NN, et al. Colonic perforation in unsuspected amebic colitis. Dig Dis Sci. 2000;45(9):1836-41.
Abbas, M. A., Mulligan, D. C., Ramzan, N. N., Blair, J. E., Smilack, J. D., Shapiro, M. S., Lidner, T. K., & Olden, K. W. (2000). Colonic perforation in unsuspected amebic colitis. Digestive Diseases and Sciences, 45(9), 1836-41.
Abbas MA, et al. Colonic Perforation in Unsuspected Amebic Colitis. Dig Dis Sci. 2000;45(9):1836-41. PubMed PMID: 11052328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colonic perforation in unsuspected amebic colitis. AU - Abbas,M A, AU - Mulligan,D C, AU - Ramzan,N N, AU - Blair,J E, AU - Smilack,J D, AU - Shapiro,M S, AU - Lidner,T K, AU - Olden,K W, PY - 2000/10/29/pubmed PY - 2001/2/28/medline PY - 2000/10/29/entrez SP - 1836 EP - 41 JF - Digestive diseases and sciences JO - Dig Dis Sci VL - 45 IS - 9 N2 - 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. SN - 0163-2116 UR - https://www.unboundmedicine.com/medline/citation/11052328/Colonic_perforation_in_unsuspected_amebic_colitis_ DB - PRIME DP - Unbound Medicine ER -