CHRONIC AMEBIC-COLITIS MISTAKEN FOR ULCERATIVE-COLITIS

Objective: Description of the clinical presentation and follow-up of a patient with chronic amoebic colitis misdiagnosed as idiopathic ulcerative colitis. Design: Retrospective. Setting: Tertiary. Patient: A 15-year-old boy, with a 5-year history of bloody diarrhoea, who had never been abroad. Interventions: Sigmoidoscopy, examination of fresh exudate and rectal biopsy. Outcome: Trophozoites of Entamoeba histolytica were found in scrapings from bowel ulcers and in rectal biopsy 5 years after the onset of the symptoms. Moreover, when the rectal biopsy taken at the onset of the disease was observed in multiple serial section, vegetative E. histolytica were also identified. This shows that amoeba could easily be missed in a routine histological section. Results: The patient was successfully treated with metronidazole. Conclusions: Possible amoebiasis should be considered both in patients recently diagnosed as having ulcerative colitis and in those with chronic and recurrent symptoms, particularly when they do not respond to treatment as expected.