Lfaquir Fatima Zahra, Zouaoui Imane, Zimi Khalil, Aoufi Sarra
Central Laboratory of Parasitology and Mycology, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR.
Cureus. 2025 Jun 27;17(6):e86866. doi: 10.7759/cureus.86866. eCollection 2025 Jun.
Introduction Amoebiasis, caused by the protozoan parasite , remains a significant public health concern in our country due to its endemicity. It poses a unique challenge in patients with inflammatory bowel disease (IBD), where its symptoms often mimic disease flare-ups, leading to diagnostic uncertainty and potential delays in appropriate management. The overlap in clinical presentation between amoebiasis and IBD exacerbations can result in misdiagnosis or inappropriate treatment, further complicating patient outcomes. In this context, our study was designed to explore and describe the epidemiological profile of intestinal amoebiasis specifically in the IBD patient population. By identifying patterns of co-infection, risk factors, and clinical manifestations, we aim to enhance early recognition and guide targeted diagnostic and therapeutic strategies. This is particularly important for improving outcomes and optimizing care in regions where amoebiasis remains endemic. Materials and methods This retrospective study examined 684 stool samples from IBD patients sent to the central parasitology-mycology laboratory at Ibn Sina University Hospital in Rabat between June 2014 and July 2022. A positive diagnosis was established through parasitological examination of stool (PES) samples using a combination of fresh examination and two concentration techniques: Merthiolate-Iodine-Formol and Bailenger. Results Of the 684 stool samples collected from patients with IBD, 162 tested positive, representing a prevalence rate of 24%. Of these, 78 were from patients with ulcerative colitis (UC), 67 with Crohn's disease (CD), and 17 with indeterminate IBD. Twenty patients were in remission at the time of the study: ten with UC, seven with CD, and three with unspecified IBD. The majority of patients were adults (159 cases), with a female predominance (sex ratio M:F = 0.7). In our study, intestinal parasitism showed a predominance of (60%), followed by the cystic form of the parasite (23%). Both forms were present in 14% of cases. Conclusion According to the literature, amoebiasis can mimic or exacerbate the clinical manifestations of IBD, complicating the differential diagnosis and increasing the risk of inadequate treatment in the absence of systematic PES samples. These results corroborate the findings of our study, which highlight the need for early diagnosis and appropriate management of IBD to prevent complications.
引言 由原生动物寄生虫引起的阿米巴病,因其在我国的地方性流行,仍然是一个重大的公共卫生问题。它给炎症性肠病(IBD)患者带来了独特的挑战,其症状常常类似于疾病发作,导致诊断不确定性以及在适当管理方面可能出现延误。阿米巴病和IBD加重在临床表现上的重叠可能导致误诊或不适当的治疗,进一步使患者的治疗结果复杂化。在此背景下,我们的研究旨在探索和描述肠道阿米巴病在IBD患者群体中的流行病学特征。通过识别合并感染模式、风险因素和临床表现,我们旨在加强早期识别并指导针对性的诊断和治疗策略。这对于改善阿米巴病仍然流行地区的治疗结果和优化护理尤为重要。
材料与方法 这项回顾性研究检查了2014年6月至2022年7月期间送往拉巴特伊本·西那大学医院中央寄生虫学-真菌学实验室的684份IBD患者的粪便样本。通过使用新鲜检查和两种浓缩技术(硫柳汞-碘-甲醛和贝伦杰)对粪便(PES)样本进行寄生虫学检查来确立阳性诊断。
结果 在从IBD患者收集的684份粪便样本中,162份检测呈阳性,患病率为24%。其中,78份来自溃疡性结肠炎(UC)患者,67份来自克罗恩病(CD)患者,17份来自不确定型IBD患者。20名患者在研究时处于缓解期:10名患有UC,7名患有CD,3名患有未明确类型的IBD。大多数患者为成年人(159例),女性占优势(性别比M:F = 0.7)。在我们的研究中,肠道寄生虫感染以滋养体形式为主(60%),其次是寄生虫的包囊形式(23%)。两种形式均存在于14%的病例中。
结论 根据文献,阿米巴病可模仿或加重IBD的临床表现,在没有系统的PES样本的情况下使鉴别诊断复杂化并增加治疗不足的风险。这些结果证实了我们研究的发现,该研究强调了对IBD进行早期诊断和适当管理以预防并发症的必要性。