Abstract
Amoebiasis is a parasitic infection caused by the protozoan, Entamoeba histolytica. At times, amoebiasis is activated under immunosuppressive conditions such as chemotherapy. We report a case of fulminant amoebic colitis resulting from an asymptomatic Entamoeba histolytica infection, which was activated by chemotherapy for gastric cancer. The patient developed diarrhea and fever after three courses of chemotherapy for gastric cancer and was diagnosed with acute enteritis. A colonoscopy and biopsy were performed because of the bloody stool. Histopathological findings revealed amoebic invasion of the rectum. Therefore, the patient was diagnosed with amoebic colitis and was treated with metronidazole. Emergency surgery was performed because intestinal perforation was suspected after which his general condition improved and was discharged. Subsequently, gastric cancer surgery was performed and the patient was discharged without postoperative complications. Hence, amoebic colitis should be listed as a differential diagnosis, and a colonoscopic biopsy should be performed when colitis occurs during chemotherapy for cancer.
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References
Haque R, Huston CD, Hughes M, et al. Amebiasis. N Engl J Med. 2003;348:1565–73.
Andrade JE, Mederos R, Rivero H, et al. Amebiasis presenting as acute appendicitis. South Med J. 2007;100:1140–2.
Blumencranz H, Kasen L, Romeu J, et al. The role of endoscopy in suspected amebiasis. Am J Gastroenterol. 1983;78:15–8.
Sato Y, Kurokawa Y, Doki Y, et al. A Phase II study of preoperative chemotherapy with docetaxel, oxaliplatin and S-1 in gastric cancer with extensive lymph node metastasis (JCOG1704). Future Oncol. 2020;16:31–8.
Kitaoka A, Tanimura K, Yasuda Y, et al. Successful treatment with metronidazole and paromomycin for fulminant amoebic colitis during cytotoxic chemotherapy in a patient with small-cell lung cancer. IDCases. 2021;26:e01337.
Hanaoka N, Higuchi K, Tanabe S, et al. Fulminant amoebic colitis during chemotherapy for advanced gastric cancer. World J Gastroenterol. 2009;15:3445–7.
Chaturvedi R, Gupte PA, Joshi AS. Fulminant amoebic colitis: a clinicopathological study of 30 cases. Postgrad Med J. 2015;91:200–5.
Shirley DA, Moonah S. Fulminant amebic colitis after corticosteroid therapy: A systematic review. PLOS Negl Trop Dis. 2016;10:e0004879.
Nagata N, Shimbo T, Sekine K, et al. Combined endoscopy, aspiration, and biopsy analysis for identifying infectious colitis in patients with ileocecal ulcers. Clin Gastroenterol Hepatol. 2013;11:673-80.e2.
Patterson M, Healy GR, Shabot JM. Serologic testing for amoebiasis. Gastroenterology. 1980;78:136–41.
Heil TC, Dercksen MW, Blank SN. Infection or metastases? The amoebic abscess. Ned Tijdschr Geneeskd. 2018;11:162.
Kishihara T, Uragami N, Igarashi M, et al. Study on amebic colotis-espesally differential diagnosis from IBD. Prog Dig Endosc. 2008;2:77–9.
Tomino T, Ninomiya M, Minagawa R, et al. Lethal multiple colon necrosis and perforation due to fulminant amoebic colitis: a surgical case report and literature review. Surg Case Rep. 2021;7:27.
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Takiguchi, N., Hata, T., Saito, T. et al. A case of fulminant amoebic colitis during systemic chemotherapy for gastric cancer. Clin J Gastroenterol 16, 689–692 (2023). https://doi.org/10.1007/s12328-023-01835-5
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DOI: https://doi.org/10.1007/s12328-023-01835-5