EC Gastroenterology and Digestive System

Amoebiasis is a parasitic disease caused by a protozoan parasite called Entamoeba histolytica found worldwide and mostly in low- and middle-income countries. Amoebiasis colitis is mostly revealed by acute diarrhea, bloody or non- bloody and abdominal pain, and the use of steroids is the main risk factor of developing fulminant colitis, thus identifying the right diagnosis is particularly important, since the main differential diagnosis is Ulcerative Colitis which steroids are one of the cornerstones of treatment. In addition, the association of amoebiasis colitis and Ulcerative Colitis is frequent, it may trigger and/or worsening the fare-up, thus confronting the clinician to a dilemma of managing the clinical state. We report below a case that illustrate the dilemma of managing amebiasis colitis associated to Ulcerative Colitis.

Keywords: IBD; Amoebiasis; Dilemma; Diagnosis; Management

1. Haque R., et al. “Innate and acquired resistance to amebiasis in bangladeshi children”. The Journal of Infectious Diseases4 (2002): 547-552.
2. Choudhuri G and Murali R. “Amebic infection in humans”. Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology4 (2012): 153-162.
3. Stanley Samuel L. “Amoebiasis”. Lancet9362 (2003): 1025-1034.
4. Ralston KS and Petri WA. “Tissue destruction and invasion by Entamoeba histolytica”. Trends in Parasitology6 (2011): 254-263.
5. Wilson IW., et al. “Host-Parasite interactions in Entamoeba histolytica and Entamoeba dispar: what have we learned from their genomes?”. Parasite Immunology2-3 (2012): 90-99.
6. Shirley Debbie-Ann T., et al. “A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis”. Open Forum Infectious Diseases161 (2018).
7. Ngobeni R., et al. “Entamoeba Species in South Africa: Correlations with the Host Microbiome, Parasite Burdens, and First Description of Entamoeba bangladeshi Outside of Asia”. The Journal of Infectious Diseases12 (2017): 1592-1600.
8. Lozano R., et al. “Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet9859 (2012): 2095-2128.
9. Shirley Debbie-Ann and Shannon Moonah. “Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review”. PLoS Neglected Tropical Diseases7 (2016): e0004879.
10. Ozin Y., et al. “Presence and diagnosis of amebic infestation in Turkish patients with active ulcerative colitis”. European Journal of Internal Medicine5 (2009): 545-547.
11. Ryan U., et al. “New Technologies for Detection of Enteric Parasites”. Trends in Parasitology7 (2017): 532-546.
12. Simpson I., et al. “Caught in the act..a case of fulminant amoebic colitis”. JMM Case Reports4 (2015).
13. Peterson KM., et al. “Enteric amebiasis". Tropical infectious diseases: principles, pathogens and practice. WB Saunders (2011): 614-622.
14. Gonzales M., et al. “Antiamoebic drugs for treating amoebic colitis”. The Cochrane Database of Systematic Reviews1 (2019): CD006085.