Acute fulminant amoebic colitis: A Case report

Amoebiasis is a parasitic infection that represents a public health problem in developing countries including Asia and Latin America where it is endemic (1000-5000 cases/100,000 habitants/year). The majority of patients have an asymptomatic course; however, 10% of patients develop complications with high morbidity and mortality, such as colonic perforation or fulminant amoebic colitis. We report a case in which a 73-year-old female presented with an acute abdomen that was initially attributed to a bowel obstruction that rapidly progressed to fulminant colitis with bowel perforation requiring total colectomy. Pre-surgical endoscopic histopathological examination revealed findings suggestive of Entamoeba histolytica trophozoites that were later confirmed in the colon post-surgical specimen leading to a diagnosis of fulminant amoebic colitis. This atypical presentation of amoebiasis, further expands the already broad differential diagnosis of acute abdominal pathology in the elderly population. A high index of suspicion is required for its prompt treatment and to prevent life-threatening complications.