A Case of Fulminating Amebic Colitis Presenting as an Acute Abdomen

We recently saw a case of fulminating amebic colitis presenting as an acute abdomen. A 45-year-old man was admitted to our department with pain in the right lower quadrant of the abdomen and diarrhea. The white cell count was 12, 700 and abdominal examination showed signs of peritoneal inflammation. A Gastrografin enema revealed a large ulcer in the cecum. In spite of the use of antibiotics, the patient's condition continued to deteriorate. Because of the increasing risk of perforation of the ulcer, an ileocecal resection was performed. The diagnosis was not determined until trophozoites of Entamoeba histolytica were found in the resected specimen by periodic acid Schiff staining. After the correct diagnosis was made, an antiamebic drug was administered orally. The patient was cured after 12 days of antiamebic drug therapy. Only when the correct diagnosis is made and the proper therapy instituted early enough is it possible to prevent the morbidity and mortality that attend fulminating amebic colitis. Therefore, we should make the diagnosis promptly and institute the appropriate treatment.