Amoebiasis: incidence at Royal North Shore Hospital, Sydney

Seven cases of amoebiasis have been seen at the Royal North Shore Hospital of Sydney, over a nine-year period from 1968 to 1976. Six of these patients had intestinal amoebiasis; these included four with amoebic colitis, one of whom died, one patient with a rectal amoeboma, which was surgically resected, and one case of amoebic dysentery. The patients with amoebic colitis were considered initially to have either ulcerative colitis or Crohn's disease. All patients with inflammatory bowel disease should have rectal swabs or scrapings examined by warm-stage microscopy, rectal biopsy and indirect haemagglutination (IHA) tests to exclude amoebiasis. Three patients had extraintestinal amoebiasis in the form of liver abscesses and one also had pulmonary involvement. In one patient with a hepatic abscess who presented with pyrexia and no evidence of intestinal amoebiasis, the abscess ruptured intraperitoneally. Surgery was performed on three patients, in two cases before diagnosis. Metronidazole appears to be the treatment of choice for intestinal amoebiasis and amoebic liver abscesses. Amoebiasis should be considered in patients resident in Australia who have not recently travelled abroad.