Massive gastrointestinal bleeding in fulminant amebic colitis: a case report.

Area of Science:

• Infectious Diseases
• Gastroenterology
• Surgical Pathology

Background:

• Amebiasis, caused by Entamoeba histolytica, is a significant global health issue.
• Fulminant amebic colitis (FAC) is a rare, severe complication of amebiasis.
• Massive lower gastrointestinal bleeding is an exceptionally uncommon manifestation of FAC.

Purpose of the Study:

• To report a rare case of fulminant amebic colitis with massive lower GI bleeding.
• To highlight diagnostic challenges and management strategies for this rare presentation.

Main Methods:

• Case report of a 27-year-old male with no prior medical history.
• Clinical presentation: fever, abdominal pain, diarrhea, massive hematochezia.
• Diagnostic tools: imaging (liver abscesses, cecal thickening), emergency laparotomy, histopathology (amebic colitis).
• Intervention: right hemicolectomy, abscess drainage, antimicrobial therapy (metronidazole, paromomycin).

Main Results:

• The patient presented with severe symptoms and was diagnosed with amebic colitis and liver abscesses.
• Surgical intervention and antimicrobial therapy led to an uneventful recovery.
• Histopathology confirmed flask-shaped ulcers characteristic of amebic colitis.

Conclusions:

• Fulminant amebic colitis with massive GI bleeding is rare but potentially fatal.
• Diagnostic challenges exist, especially in atypical cases; advanced imaging and histopathology are key.
• Integrated surgical and antimicrobial management is essential for favorable outcomes.