[Severe forms of hemorrhagic rectocolitis. Predisposing role of the amebic graft?]

Severe forms of ulcerative colitis are somewhat rare but have a severe prognosis. Apart from the usual predisposing factors, the amebic graft must be especially emphasized, at least in those countries where the parasite is endemic. Entamoeba histolytica was consistently identified in 19 cases of the severe form that we found out of a total of 126 cases of ulcerative colitis. Usually the parasite was found in the shape of massive infestation and in most cases it proved to be resistant to the amebicides currently available. The clinical picture shown by the 19 patients was identical to that given in the literature for severe forms of ulcerative colitis. Therapeutically, it was essential to combine one (or, if necessary, several) course(s) of treatment with amebicides with the usual therapeutic measures until the parasite was destroyed in the intestine. This work suggests that any attack on ulcerative colitis must automatically include an anti-amebic course of treatment, and this should strictly precede any corticosteroid therapy, even administered as enemas.