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Clinical manifestations and endoscopic findings of amebic colitis in a United States-Mexico border city: a case series.
BMC Res Notes. 2015 Dec 14; 8:781.BR

Abstract

BACKGROUND

Invasive amebiasis is not frequently seen in the United States. It is associated with considerable morbidity in patients residing in or traveling to endemic areas. We report a case series of patients with amebic colitis in a United States-Mexico border city to alert physicians to the varied clinical manifestations.

CASE PRESENTATION

Nine patients were diagnosed with amebic colitis. Mean age was 56 (38-83), 6 were males, and all were Hispanic. Common symptoms were diarrhea (56 %), hematochezia (33 %) and abdominal bloating (11 %). The diagnosis of amebic colitis was established in the following ways: 8 patients by colonoscopy with biopsy, 1 by surgery for colonic obstruction. The diagnosis of amebic colitis was confirmed in 8 patients (89 %) by amebic trophozoites present in histopathologic sections. One patient was diagnosed with amebic colitis based upon clinical symptoms, colitis on colonoscopy and visualization of amebic trophozoites on stool examination. In the 8 patients in whom colonoscopy was done, 6 (75 %) had inflammation with rectosigmoid involvement and 5 (62.5 %) had ulcerations. Infection resolved after treatment with metronidazole in most patients; however, one patient developed a liver abscess and another had a colonic perforation and later developed a liver abscess.

CONCLUSION

The occurrence of amebic colitis in this United States-Mexico border city hospital population was low, but in some cases potentially life-threatening. Physicians should be alert to the less common presentations of amebic colitis, such as overt gastrointestinal bleeding, exacerbation of inflammatory bowel disease, and the incidental finding of association with colon cancer, or a surgical abdomen. Rectosigmoid involvement was typically found on colonoscopy.

Authors+Show Affiliations

Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. rfleming5006@sbcglobal.net.Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. chad.cooper@ttuhsc.edu.Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. ramirezvegamd@gmail.com.Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. gidoc80@gmail.com.Department of Pathology, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. darius.boman@ttuhsc.edu.Department of Internal Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, El Paso, TX, 79905, USA. marc.zuckerman@ttuhsc.edu.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26666636

Citation

Fleming, Rhonda, et al. "Clinical Manifestations and Endoscopic Findings of Amebic Colitis in a United States-Mexico Border City: a Case Series." BMC Research Notes, vol. 8, 2015, p. 781.
Fleming R, Cooper CJ, Ramirez-Vega R, et al. Clinical manifestations and endoscopic findings of amebic colitis in a United States-Mexico border city: a case series. BMC Res Notes. 2015;8:781.
Fleming, R., Cooper, C. J., Ramirez-Vega, R., Huerta-Alardin, A., Boman, D., & Zuckerman, M. J. (2015). Clinical manifestations and endoscopic findings of amebic colitis in a United States-Mexico border city: a case series. BMC Research Notes, 8, 781. https://doi.org/10.1186/s13104-015-1787-3
Fleming R, et al. Clinical Manifestations and Endoscopic Findings of Amebic Colitis in a United States-Mexico Border City: a Case Series. BMC Res Notes. 2015 Dec 14;8:781. PubMed PMID: 26666636.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical manifestations and endoscopic findings of amebic colitis in a United States-Mexico border city: a case series. AU - Fleming,Rhonda, AU - Cooper,Chad J, AU - Ramirez-Vega,Ruben, AU - Huerta-Alardin,Ana, AU - Boman,Darius, AU - Zuckerman,Marc J, Y1 - 2015/12/14/ PY - 2015/02/13/received PY - 2015/12/02/accepted PY - 2015/12/16/entrez PY - 2015/12/17/pubmed PY - 2016/9/22/medline SP - 781 EP - 781 JF - BMC research notes JO - BMC Res Notes VL - 8 N2 - BACKGROUND: Invasive amebiasis is not frequently seen in the United States. It is associated with considerable morbidity in patients residing in or traveling to endemic areas. We report a case series of patients with amebic colitis in a United States-Mexico border city to alert physicians to the varied clinical manifestations. CASE PRESENTATION: Nine patients were diagnosed with amebic colitis. Mean age was 56 (38-83), 6 were males, and all were Hispanic. Common symptoms were diarrhea (56 %), hematochezia (33 %) and abdominal bloating (11 %). The diagnosis of amebic colitis was established in the following ways: 8 patients by colonoscopy with biopsy, 1 by surgery for colonic obstruction. The diagnosis of amebic colitis was confirmed in 8 patients (89 %) by amebic trophozoites present in histopathologic sections. One patient was diagnosed with amebic colitis based upon clinical symptoms, colitis on colonoscopy and visualization of amebic trophozoites on stool examination. In the 8 patients in whom colonoscopy was done, 6 (75 %) had inflammation with rectosigmoid involvement and 5 (62.5 %) had ulcerations. Infection resolved after treatment with metronidazole in most patients; however, one patient developed a liver abscess and another had a colonic perforation and later developed a liver abscess. CONCLUSION: The occurrence of amebic colitis in this United States-Mexico border city hospital population was low, but in some cases potentially life-threatening. Physicians should be alert to the less common presentations of amebic colitis, such as overt gastrointestinal bleeding, exacerbation of inflammatory bowel disease, and the incidental finding of association with colon cancer, or a surgical abdomen. Rectosigmoid involvement was typically found on colonoscopy. SN - 1756-0500 UR - https://www.unboundmedicine.com/medline/citation/26666636/Clinical_manifestations_and_endoscopic_findings_of_amebic_colitis_in_a_United_States_Mexico_border_city:_a_case_series_ L2 - https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1787-3 DB - PRIME DP - Unbound Medicine ER -