Fulminant necrotising amoebic colitis: A diagnostic conundrum

Area of Science:

• Gastroenterology
• Infectious Diseases
• Tropical Medicine

Background:

• Fulminant necrotising amoebic colitis is a severe complication of untreated amoebiasis.
• It disproportionately affects low-income countries and carries a high mortality rate.
• Diagnosis can be challenging due to its rarity and non-specific presentation.

Purpose of the Study:

• To report an extremely rare case of fulminant necrotising amoebic colitis.
• To illustrate the diagnostic difficulties encountered in such cases.
• To emphasize the importance of considering amoebic colitis in the differential diagnosis of acute abdomen.

Main Methods:

• Case report presentation.
• Review of clinical presentation, diagnostic workup, and management.
• Comparison with typical presentations of acute abdomen.

Main Results:

• The patient presented with symptoms mimicking an acute abdomen, specifically a perforated duodenal ulcer.
• Diagnostic confusion arose due to the atypical presentation of amoebic colitis.
• Prompt recognition and treatment were crucial for patient outcomes.

Conclusions:

• Fulminant necrotising amoebic colitis can present atypically, mimicking surgical emergencies like perforated duodenal ulcers.
• Early and accurate diagnosis is critical for reducing mortality in amoebiasis.
• Awareness among clinicians is essential for appropriate management, especially in endemic regions.