FULMINANT AMEBIC-COLITIS - A MORPHOLOGIC STUDY OF 4 CASES

PURPOSE: The morphologic features of fulminant amebic colitis are poor ly documented. In this report, we describe the clinical and pathologic findings in four of these cases. METHODS: The surgical pathology repo rts and accompanying histologic slides were examined from four patient s who underwent surgical resections for fulminant amebic colitis. Clin ical information was obtained from the patients' medical records. RESU LTS: Large, geographic mucosal ulcers were typically present and were accompanied by yellow-green pseudomembranes. The muscularis externa wa s usually attenuated and necrotic, imparting a ''wet blotting paper'' consistency. Large numbers of amebic trophozoites were present within the inflammatory exudates. The mucosa adjacent to and undermined by th e ulcers was often hemorrhagic or inflamed, resembling ischemic coliti s or idiopathic inflammatory bowel disease, respectively. Two patients died within four weeks of their surgery. A third patient died one yea r later as a result of AIDS-related complications. The remaining patie nt has been lost to follow-up. CONCLUSION: An uncommon but life-threat ening manifestation of intestinal amebiasis is a fulminant colitis. Ea rly surgical intervention and intensive antiamebic chemotherapy are es sential for efficacious managment.