Hamdi Ghaith, Zaghdoudi Aida, Frikha Mohamed Taieb, Makhlouf Mounir, Sassi Karim, Ben Badr Mourad, Ben Slima Mohamed
General Surgery Department, Hopital La Rabta, Tunis, Tunisia.
Infectious Diseases Department, Hopital La Rabta, Tunis, Tunisia.
Int J Surg Case Rep. 2021 Feb;79:466-469. doi: 10.1016/j.ijscr.2021.01.068. Epub 2021 Jan 20.
Amoebiasis is a parasitosis, mainly caused by Entamoeba histolytica (E. histolytica). It is a common disease in tropical and subtropical regions. E. histolytica possesses different mechanisms of pathogenicity, and might lead to the invasion and lysis of the intestinal epithelium. Outside of the high-risk regions, acute intestinal amoebiasis is a very rare condition, often leading to misdiagnosis and death, if not promptly treated. We discuss the cases of 18 and 43 year-old men without medical history, who presented to the emergency department complaining of acute abdominal pain along with fever. Following imaging features and clinical presentation, appendicitis and a complicated form of Crohn's disease were respectively suspected. Given the severity of the symptoms, an explorative laparotomy was performed showing in both cases an inflammatory aspect of the intestine. Histological examination concluded intestinal amoebiasis, a diagnosis that wasn't suspected at first. The learning point of these cases is considering invasive intestinal amoebiasis in patients presenting with an acute abdominal syndrome, even with no history of traveling abroad or immunodeficiency.
阿米巴病是一种寄生虫病，主要由溶组织内阿米巴（痢疾阿米巴）引起。它是热带和亚热带地区的常见疾病。痢疾阿米巴具有不同的致病机制，可能导致肠道上皮的侵袭和溶解。在高危地区之外，急性肠道阿米巴病是一种非常罕见的病症，如果不及时治疗，常常会导致误诊和死亡。我们讨论了两名分别为18岁和43岁且无病史的男性病例，他们因急性腹痛伴发热到急诊科就诊。根据影像学特征和临床表现，分别怀疑为阑尾炎和复杂性克罗恩病。鉴于症状的严重性，进行了剖腹探查术，结果在两例中均显示肠道有炎症表现。组织学检查确诊为肠道阿米巴病，这一诊断起初并未被怀疑。这些病例的经验教训是，对于出现急性腹部综合征的患者，即使没有出国旅行史或免疫缺陷，也应考虑侵袭性肠道阿米巴病。
