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Fulminant amebic colitis: a study of six cases.
Indian J Pathol Microbiol. 2009 Jul-Sep; 52(3):370-3.IJ

Abstract

BACKGROUND

Amebic colitis although common, rarely presents as fulminant colitis which has a high morbidity and mortality unless treated promptly and appropriately.

AIM

To study the clinical, morphological features and outcome of fulminant amebic colitis (FAC).

MATERIALS AND METHODS

A retrospective study of six patients who underwent surgical resections from 2002-06 and were diagnosed with FAC, was carried out. The morphological features assessed included the average number of trophozoites per high-power field and the depth of invasion of trophozoites into the muscularis propria.

RESULTS

The study included five adults and one child who underwent surgery for fulminant colitis. Interestingly, a definite preoperative diagnosis of amebic colitis was made only in one patient and suspected in another. Intraoperatively, multiple perforations of the intestine with peritonitis were the most common findings. Gross examination typically revealed multiple ulcers with exudate and intervening normal mucosa. Microscopically, ulceration and myonecrosis with trophozoites within the exudate were seen in all cases. Trophozoites invading the muscularis propria were seen in five cases. Of the cases that showed myoinvasion by trophozoites, two patients expired within two weeks of surgery. One of the patients who expired also showed co-infection with Actinomyces.

CONCLUSION

FAC is an uncommon outcome in amebic colitis with a high mortality requiring prompt surgical intervention.

Authors+Show Affiliations

Department of Pathology, St. John's Medical College, Bangalore, India.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19679964

Citation

Nisheena, R, et al. "Fulminant Amebic Colitis: a Study of Six Cases." Indian Journal of Pathology & Microbiology, vol. 52, no. 3, 2009, pp. 370-3.
Nisheena R, Ananthamurthy A, Inchara YK. Fulminant amebic colitis: a study of six cases. Indian J Pathol Microbiol. 2009;52(3):370-3.
Nisheena, R., Ananthamurthy, A., & Inchara, Y. K. (2009). Fulminant amebic colitis: a study of six cases. Indian Journal of Pathology & Microbiology, 52(3), 370-3. https://doi.org/10.4103/0377-4929.54997
Nisheena R, Ananthamurthy A, Inchara YK. Fulminant Amebic Colitis: a Study of Six Cases. Indian J Pathol Microbiol. 2009 Jul-Sep;52(3):370-3. PubMed PMID: 19679964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fulminant amebic colitis: a study of six cases. AU - Nisheena,R, AU - Ananthamurthy,Anuradha, AU - Inchara,Y K, PY - 2009/8/15/entrez PY - 2009/8/15/pubmed PY - 2009/10/10/medline SP - 370 EP - 3 JF - Indian journal of pathology & microbiology JO - Indian J Pathol Microbiol VL - 52 IS - 3 N2 - BACKGROUND: Amebic colitis although common, rarely presents as fulminant colitis which has a high morbidity and mortality unless treated promptly and appropriately. AIM: To study the clinical, morphological features and outcome of fulminant amebic colitis (FAC). MATERIALS AND METHODS: A retrospective study of six patients who underwent surgical resections from 2002-06 and were diagnosed with FAC, was carried out. The morphological features assessed included the average number of trophozoites per high-power field and the depth of invasion of trophozoites into the muscularis propria. RESULTS: The study included five adults and one child who underwent surgery for fulminant colitis. Interestingly, a definite preoperative diagnosis of amebic colitis was made only in one patient and suspected in another. Intraoperatively, multiple perforations of the intestine with peritonitis were the most common findings. Gross examination typically revealed multiple ulcers with exudate and intervening normal mucosa. Microscopically, ulceration and myonecrosis with trophozoites within the exudate were seen in all cases. Trophozoites invading the muscularis propria were seen in five cases. Of the cases that showed myoinvasion by trophozoites, two patients expired within two weeks of surgery. One of the patients who expired also showed co-infection with Actinomyces. CONCLUSION: FAC is an uncommon outcome in amebic colitis with a high mortality requiring prompt surgical intervention. SN - 0974-5130 UR - https://www.unboundmedicine.com/medline/citation/19679964/Fulminant_amebic_colitis:_a_study_of_six_cases_ L2 - http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2009;volume=52;issue=3;spage=370;epage=373;aulast=Nisheena DB - PRIME DP - Unbound Medicine ER -