alexa A Case of Fulminant Amebic Colitis Diagnosed after Colo
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

A Case of Fulminant Amebic Colitis Diagnosed after Colonic Resection

Tatsuya Ishii1*, Nobuhiro Takeuchi1, Masanori Takada1, Akihito Otsuka2 and Yusuke Nomura2
1Division of Emergency Medicine, Department of Internal Medicine, Kawasaki Hospital, Japan
2Department of Internal Medicine, Kawasaki Hospital,3-3-1 Higashiyama-cho, Hyogo-ku, Kobe-shi, Hyogo 652-0042, Japan
*Corresponding Author : Tatsuya Ishii
Division of Emergency Medicine
Department of Internal Medicine, Kawasaki Hospital, Japan
Tel: +81-78-511-3131
Fax: +81-78-511-3138
E-mail: [email protected]
Rec date: Feb 09, 2016; Acc date: Mar 05, 2016; Pub date: Mar 08, 2016
Citation: Ishii T, Takeuchi N, Takada M, Otsuka A, Nomura Y (2016) A Case of Fulminant Amebic Colitis Diagnosed after Colonic Resection. J Clin Case Rep 6:736. doi:10.4172/2165-7920.1000736
Copyright: © 2016 Ishii T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Here, we report a case of fulminant amebic colitis diagnosed after colonic resection in a 66-year-old male who visited our hospital complaining of prolonged fever and consistent pain in the right abdomen. The patient had neither watery nor bloody stool. Laboratory data revealed increased white blood cell counts (15,900 cells/μl) and high levels of C-reactive protein (10.3 mg/dl). Contrast enhanced computed tomography revealed remarkably hypertrophic and edematous lesions in the right-sided colon. Stool culture revealed no pathogens. The patient was suspected to have infectious colitis; thereafter, the antibiotic flomoxef sodium (3 g/day) was administered. Colonoscopy revealed a circumferential white coat and stripped mucosal lesions in the right-sided colon; thereafter, ischemic colitis or enterohemorrhagic Escherichia coli colitis was the differential diagnosis. When the general condition of the patient and their inflammatory response deteriorated, surgical treatment was adopted. Surgical findings revealed a rightsided necrotizing colon and yellowish ascites, which was later found to contain Enterococcus faecalis and grampositive bacillus. Pathological findings revealed the presence of trophozoites of Entamoeba histolytica. Consequently, fulminant amebic colitis was diagnosed. The postoperative course was uneventful, and the patient was discharged on postoperative day 18.

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