CHRONOLOGICAL DEVELOPMENT OF CLINICAL FEATURES IN A CASE OF FULMINANT AMEBIC COLITIS: A CASE REPORT
Abstract
Introduction: Amebiasis is a parasitic infection usually limited to endemic areas, caused by the protozoa Entamoeba histolytica. Fulminant amebic colitis is its rare, rapidly progressing, life-threatening variant reported from many countries all over the world.
Case Report: Present case started as malaise and fever not responding to antibiotics. Fever was spiking by third and fourth days with postprandial rigors, relative bradycardia, and hypotension. Abdominal pain was rapidly increasing with flatulence and distension on the fourth day evening. Abdominal distention and pain were relieved and the temperature was normal after the first intravenous infusion of metronidazole.
Conclusion: Fulminant amebic colitis may be seen in any country all over the world due to increasing international travel, import of food materials, HIV infection, and immune deficiency. None of the clinical features is specific or diagnostic for fulminant amebic colitis. Fulminant amebic colitis should be considered in all cases of acute abdomen, and fever not responding to antibiotics with postprandial rigors and/or pain abdomen. Suspicion and immediate institution of specific treatment (Intravenous metronidazole infusion) is life-saving. All cases should be evaluated for colonic perforations and surgical intervention.
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