Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 E2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Clin J Gastroenterol. 2023 Oct;16(5):689-692. doi: 10.1007/s12328-023-01835-5. Epub 2023 Aug 16.
Amoebiasis is a parasitic infection caused by the protozoan, Entamoeba histolytica. At times, amoebiasis is activated under immunosuppressive conditions such as chemotherapy. We report a case of fulminant amoebic colitis resulting from an asymptomatic Entamoeba histolytica infection, which was activated by chemotherapy for gastric cancer. The patient developed diarrhea and fever after three courses of chemotherapy for gastric cancer and was diagnosed with acute enteritis. A colonoscopy and biopsy were performed because of the bloody stool. Histopathological findings revealed amoebic invasion of the rectum. Therefore, the patient was diagnosed with amoebic colitis and was treated with metronidazole. Emergency surgery was performed because intestinal perforation was suspected after which his general condition improved and was discharged. Subsequently, gastric cancer surgery was performed and the patient was discharged without postoperative complications. Hence, amoebic colitis should be listed as a differential diagnosis, and a colonoscopic biopsy should be performed when colitis occurs during chemotherapy for cancer.
阿米巴病是由原生动物溶组织内阿米巴引起的寄生虫感染。有时，在免疫抑制条件下，如化疗，阿米巴病会被激活。我们报告了一例由胃癌化疗引起的无症状溶组织内阿米巴感染引起的暴发性阿米巴结肠炎。该患者在接受三周期胃癌化疗后出现腹泻和发热，并被诊断为急性肠炎。由于出现血便，进行了结肠镜检查和活检。组织病理学检查显示直肠有阿米巴侵犯。因此，该患者被诊断为阿米巴结肠炎，并接受甲硝唑治疗。由于怀疑肠穿孔，紧急手术，之后患者一般情况改善并出院。随后，进行了胃癌手术，患者无术后并发症出院。因此，在癌症化疗期间发生结肠炎时，应将阿米巴结肠炎列为鉴别诊断，并进行结肠镜活检。
