Ishioka Haruhiko, Umezawa Masami, Hatakeyama Shuji
Department of Internal Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital, Japan.
Intern Med. 2011;50(22):2851-4. doi: 10.2169/internalmedicine.50.5411. Epub 2011 Nov 15.
We present a case of fulminant amebic colitis in a human immunodeficiency virus (HIV)-infected homosexual man. The patient developed colonic perforation over a short time despite empirical therapy with metronidazole, and underwent right hemicolectomy. Amebic colitis was pathologically diagnosed by identifying invasive trophozoites of Entamoeba in a surgical specimen. Amebic colitis is one of the important differential diagnoses of acute abdomen in HIV-infected patients and/or homosexual men, especially in East Asia. Although fulminant amebic colitis is a rare manifestation of amebiasis, early diagnosis and treatment are thought to be important to improve the outcome of this highly fatal complication.
我们报告一例在感染人类免疫缺陷病毒(HIV)的同性恋男性中发生的暴发性阿米巴结肠炎病例。尽管给予甲硝唑经验性治疗,患者仍在短时间内出现结肠穿孔,并接受了右半结肠切除术。通过在手术标本中识别溶组织内阿米巴的侵袭性滋养体,病理诊断为阿米巴结肠炎。阿米巴结肠炎是HIV感染患者和/或同性恋男性急性腹痛的重要鉴别诊断之一,尤其是在东亚地区。尽管暴发性阿米巴结肠炎是阿米巴病的罕见表现,但早期诊断和治疗对于改善这种高度致命并发症的预后被认为很重要。