Fulminant necrotizing amoebic colitis presenting as acute appendicitis: a case report and comprehensive literature review
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Published version
Author(s)
Type
Journal Article
Abstract
Intestinal amoebiasis is a parasitic infection caused by Entamoeba histolytica. It is commonly found in developing countries with poor hygiene. A rare, life-threatening complication of amoebiasis is fulminant necrotizing amoebic colitis (FulNAC). We report a 59-year-old male with acute lower right abdominal pain. Before coming to our institution, he was diagnosed with acute appendicitis. Extensive necrosis near the caecum involving the appendix and colon was observed intraoperatively. The patient underwent a right hemicolectomy, followed by an ileostomy and colostomy. Histopathologic examination confirmed the diagnosis of FulNAC. After the surgery, the patient was transferred to the high care unit and treated with metronidazole after histopathologic findings confirmed the etiology. The patient showed excellent response to the antibiotic prescribed, and the symptoms subsided. He was discharged from the hospital on day nine. Additionally, we reviewed fifty-one existing case reports on invasive intestinal amoebiasis worldwide, confirmed by histopathological examination following their preoperative diagnosis, surgery, pharmacology treatment, and outcomes. The learning point of this case is that intestinal amoebiasis should be considered a differential diagnosis for patients around fifty years old with bowel symptoms and travel history or living in tight quarters. Blood tests, radiological examinations, and serological evaluations are valuable diagnostic modalities. Metronidazole should be given as early as possible, and health promotion is recommended to prevent this disease in the population.
Date Issued
2022-04
Date Acceptance
2021-11-03
Citation
The Journal of Infection in Developing Countries, 2022, 16 (4), pp.717-725
ISSN
1972-2680
Publisher
The Journal of Infection in Developing Countries Non-Profit organization
Start Page
717
End Page
725
Journal / Book Title
The Journal of Infection in Developing Countries
Volume
16
Issue
4
Copyright Statement
Copyright © 2022 Rahadiani et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
distribution, and reproduction in any medium, provided the original work is properly cited.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35544636
Subjects
Acute Disease
Appendicitis
Dysentery, Amebic
Entamoeba histolytica
Humans
Intestines
Male
Metronidazole
Middle Aged
amoebiasis
Indonesia
intestinal
metronidazole
necrosis
Publication Status
Published
Coverage Spatial
Italy
Date Publish Online
2022-04-30