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Crohn's colitis complicated by superimposed invasive amebic colitis.
J Lysy1, J Zimmerman, Y Sherman
1Department of Gastroenterology, Hadassah University Hospital, Jerusalem, Israel.
The American Journal of Gastroenterology
|August 1, 1991
Summary
Distinguishing inflammatory bowel disease (IBD) from amebic colitis can be challenging, especially when diagnostic tests for Entamoeba histolytica are negative. This case highlights the importance of considering amebiasis in endemic regions with persistent IBD symptoms.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Inflammatory bowel disease (IBD) and amebic colitis share similar clinical and endoscopic features, posing diagnostic challenges for physicians.
- Distinguishing between IBD and amebic colitis is difficult, particularly in endemic regions, as diagnostic tests for Entamoeba histolytica can be negative even in invasive cases.
Observation:
- A young patient with a history of Crohn's colitis developed invasive amebic colitis while undergoing immunosuppressive therapy (steroids and 6-mercaptopurine).
- Diagnostic tests including stool specimens, biopsies, and serology for Entamoeba histolytica were negative, complicating the diagnosis.
Findings:
- The diagnosis of invasive amebic colitis was confirmed through pathological examination of a surgically resected bowel segment.
- This case illustrates a rare instance where invasive amebiasis was superimposed on pre-existing IBD.
Implications:
- Anti-amebic therapy should be considered in endemic areas for patients with persistent or unresponsive IBD symptoms.
- The findings underscore the need for heightened clinical suspicion for amebiasis in IBD patients, especially those on immunosuppressive treatment in endemic zones.