BACKGROUND: Toxic or fulminant colitis due to Entamoeba histolytica infrequently presents but is very serious. Unfortunately, there are numerous contradictory factors related to mortality. METHODS: We analyzed several cases of E. histolytica infection to determine the factors related to mortality. We included patients >15 years of age who were histopathologically diagnosed with amoebic toxic colitis and treated from January 2000 through December 2006. We evaluated demographic, clinical, laboratorial, surgical, and histopathological characteristics. RESULTS: We examined 24 patients and recorded 12 deaths (50%). Twenty patients underwent surgery within a mean time of 24 hours (range: 8-120 hours). Tenesmus and intestinal perforation were determined to be statistically significant (P<0·05) by univariate analysis. Three models of logistic regression were able to determine three statistically significant factors that affected mortality: (1) tenesmus and a lymphocyte count <1·5×10(3) cell/μl; 2) depth of invasion beyond the mucosa and a lymphocyte count <1·5×10(3) cell/μl; 3) time spent with symptoms and perforation. CONCLUSIONS: The mortality rate determined in this study is similar to previously reported series. A low lymphocyte count, significant depth of invasion, and intestinal perforation were determined to be the factors related to increased mortality, while tenesmus and limited amount of time spent with symptoms were associated with survival. Quick diagnosis and appropriate treatment are important factors that reduce mortality.
BACKGROUND: Toxic or fulminant colitis due to Entamoeba histolytica infrequently presents but is very serious. Unfortunately, there are numerous contradictory factors related to mortality. METHODS: We analyzed several cases of E. histolyticainfection to determine the factors related to mortality. We included patients >15 years of age who were histopathologically diagnosed with amoebic toxic colitis and treated from January 2000 through December 2006. We evaluated demographic, clinical, laboratorial, surgical, and histopathological characteristics. RESULTS: We examined 24 patients and recorded 12 deaths (50%). Twenty patients underwent surgery within a mean time of 24 hours (range: 8-120 hours). Tenesmus and intestinal perforation were determined to be statistically significant (P<0·05) by univariate analysis. Three models of logistic regression were able to determine three statistically significant factors that affected mortality: (1) tenesmus and a lymphocyte count <1·5×10(3) cell/μl; 2) depth of invasion beyond the mucosa and a lymphocyte count <1·5×10(3) cell/μl; 3) time spent with symptoms and perforation. CONCLUSIONS: The mortality rate determined in this study is similar to previously reported series. A low lymphocyte count, significant depth of invasion, and intestinal perforation were determined to be the factors related to increased mortality, while tenesmus and limited amount of time spent with symptoms were associated with survival. Quick diagnosis and appropriate treatment are important factors that reduce mortality.
Authors: Fernando Ramos; Patricia Morán; Enrique González; Gabriela García; Manuel Ramiro; Alejandro Gómez; María Del Carmen García DE León; Emma I Melendro; Alicia Valadez; Cecilia Ximénez Journal: Am J Trop Med Hyg Date: 2005-07 Impact factor: 2.345
Authors: K N Jalan; W Sircus; W I Card; C W Falconer; C B Bruce; G P Crean; J P McManus; W P Small; A N Smith Journal: Gastroenterology Date: 1969-07 Impact factor: 22.682
Authors: T Takahashi; A Gamboa-Dominguez; T J Gomez-Mendez; J M Remes; V Rembis; D Martinez-Gonzalez; J Gutierrez-Saldivar; J C Morales; J Granados; J Sierra-Madero Journal: Dis Colon Rectum Date: 1997-11 Impact factor: 4.585
Authors: Micaella Kantor; Anarella Abrantes; Andrea Estevez; Alan Schiller; Jose Torrent; Jose Gascon; Robert Hernandez; Christopher Ochner Journal: Can J Gastroenterol Hepatol Date: 2018-12-02
Authors: Lenin J Guzmán; Gabriel A Molina; Jaime M Cevallos; Patricio F Gálvez; Fernando X Moyon; Miguel A Moyon; Sandra C Lopez Journal: J Surg Case Rep Date: 2018-11-13