Work

Intestinal amoebiasis and pediatric inflammatory bowel disease in an endemic region: Three case reports

Year: 2026

Type: article

Abstract: BACKGROUND Differentiating superadded amoebic colitis (AC) from a disease flare in children with ulcerative colitis (UC) is challenging, particularly in endemic regions, yet remains crucial for guiding appropriate therapy and preventing adverse outcomes. CASE SUMMARY We report three children with UC and intestinal amoebiasis; two presenting as disease exacerbation and one with first presentation as acute severe colitis (ASC), highlighting key diagnostic and therapeutic dilemmas. Two children with UC, previously in clinical remission on maintenance therapy, presented with abdominal pain and bloody diarrhea; one had fever of short duration. A provisional diagnosis of disease flare was made in both. The third case presented for the first time as ASC, was treated outside with corticosteroids and referred due to non-response. Stool microscopy identified amoebic trophozoites with haemophagocytosis, consistent with Entamoeba histolytica in all. Initial anti-amoebic therapy with metronidazole resulted in transient clinical improvement; however, each patient subsequently required escalation of immunosuppression for symptom control. Our cases suggest the co-existence of AC over active UC at the same time. CONCLUSION Amoebiasis screening in endemic regions is helpful in flare of UC to avoid misdiagnosis and inappropriate escalation of immunosuppressive therapy.

Source: World Journal of Clinical Pediatrics

DOI: 10.5409/wjcp.121468

Authors: Nitu Kumari, Anshu Srivastava, Moinak Sen Sarma, Ujjal Poddar

Institution: Sanjay Gandhi Post Graduate Institute of Medical Sciences

Language: English

Topic: Amoebic Infections and Treatments

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7164182653