Abstract
Fulminant amebic colitis is a rare disease with high morbidity and mortality. PURPOSE: This study was designed to identify the most frequent clinical and histopathologic features of fulminant amebic colitis and to analyze results of surgical treatment and the existence of risk factors for mortality. MATERIALS AND METHODS: A retrospective analysis was conducted of clinical and histopathologic data of 55 patients with fulminant amebic colitis. Data were obtained from the files of autopsies and surgical operations that had been performed at a referral center in Mexico from 1943 through 1994. RESULTS: Median age was 52 (range, 18–79) years. There were 34 men (62 percent) and 21 women (38 percent). Diabetes mellitus and chronic alcoholism were the most frequent diseases in association with fulminant amebic colitis (40 and 31 percent, respectively). The most frequent clinical manifestations were abdominal pain, diarrhea, rectal bleeding, and fever. There was a co-existent amebic liver abscess in 54 percent of patients. The main histopathologic characteristics were necrosis, presence of trophozoites, and acute and/or chronic inflammation. Of 25 patients who underwent surgery, only six survived (operative mortality, 76 percent; overall mortality, 89 percent). The variables that correlated with mortality were longer duration of symptoms, lower count of leukocytes, nonsurgical treatment, nonresective surgical procedure, hospital admission before 1971, and invasion of trophozoites into or through the muscularis. CONCLUSIONS: The results may help to obtain an earlier diagnosis and establish proper treatment of fulminant amebic colitis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gutierrez G, Ludlow A, Espinosa G,et al. National serologic survey. II. Search for antibodies againstEntamoeba histolytica in Mexico. In: Sepulveda B, Diamond LS, eds. Proceedings of the International Conference on Amebiasis. Mexico: Instituto Mexicano del Seguro Social, 1976:609–18.
Martinez-Palomo A, Martinez-Baez M. Selective primary health care: strategies for control of disease in the developing world. X. Amebiasis. Rev Infect Dis 1983;5:1093–102.
Orozco H, de la Garza L, Guraieb E, Takahashi T. Tratamiento quirÚrgico de las formas graves de amibiasis intestinal. Rev Gastroenterol Mex 1988;53:23–6.
Godinez OC, Quijano NM, Jurado J, Hernandez F, Alvarez CR. Tratamiento quirurgico de la colitis amibiana fulminante. Arch Invest Med (Mex) 1970;1(Suppl 1): 237–46.
Flores BM, Reed SL, Ravdin JI, Torian BE. Serologic reactivity to purified recombinant and native 29-kilodalton peripheral membrane protein of pathogenic entamoeb histolytica. J Clin Microbiol 1993;31:1403–7.
Li E, Stanley SL. Protozoa: amebiasis. Gastroenterol Clin North Am 1996;25:471–92.
Patterson M, Healy GR, Shabot JM. Serologic testing for amoebiasis. Gastroenterology 1980;78:136–41.
Judy KL. Amebiasis presenting as an acute abdomen. Am J Surg 1974;127:275–9.
Kapur BM, Chopra P. Necrotizing amebic colitis: report of five cases. Dis Colon Rectum 1978;21:447–9.
Ellyson JH, Bezmalinovic Z, Parks SN, Lewis FR. Necrotizing amebic colitis: a frequently fatal complication. Am J Surg 1986;152:21–6.
Truelove SC, Witts LT. Cortisone in ulcerative colitis: final report on a therapeutic trial. BMJ 1955;2:1041–8.
Greenstein AJ, Greenstein RJ, Sachar DB. Toxic dilatation in amebic colitis: successful treatment without colectomy. Am J Surg 1980;139:456–8.
Guarner V, Bautista OJ, Baz DL,et al. El tratamiento quirurgico de la amibiasis invasora. Arch Invest Med (Mex) 1972;3(Suppl 2):427–32.
Perez-Tamayo R, Brand H. Amebiasis. In: Marcial-Rojas RA, ed. Pathology of protozoal and helmintic diseases with clinical correlation. 1st ed. Baltimore: Williams & Wilkins, 1971:145–88.
Masliah E, Perez-Tamayo R. Nota sobre la histopatologia de la amibiasis invasora del intestino grueso. Patologia (Mex) 1984;22:233–45.
Chun D, Chandrasoma P, Kiyabu M. Fulminant amebic colitis: a morphologic study of four cases. Dis Colon Rectum 1994;37:535–9.
Author information
Authors and Affiliations
Additional information
Read at the meeting of the Mexican Society of Coloproctology, Mexico City, Mexico, August 29 to 31, 1996.
About this article
Cite this article
Takahashi, T., Gamboa-Dominguez, A., Gomez-Mendez, T.J.M. et al. Fulminant amebic colitis. Dis Colon Rectum 40, 1362–1367 (1997). https://doi.org/10.1007/BF02050824
Issue Date:
DOI: https://doi.org/10.1007/BF02050824