Work

Clinical, Endoscopic, and Histopathological Features Distinguishing Amebic Colitis from Ulcerative Colitis in a Male Cohort: A Single-Center Retrospective Study

Year: 2026

Type: article

Abstract: Purpose: Differentiating amebic colitis (AC) from ulcerative colitis (UC) remains a significant clinical challenge. A misdiagnosis can delay appropriate treatment and even trigger life-threatening complications. Therefore, this study aimed to identify specific clinical, endoscopic features and pathological differences to facilitate accurate differential diagnosis. Patients and Methods: We retrospectively analyzed 13 AC patients with definitive histological trophozoite identification, all of whom were male. To minimize potential confounding by sex, we included 21 male patients with UC admitted during the same study period as the comparator group. Demographic characteristics, laboratory parameters, endoscopic patterns, and histopathological findings were compared. An exploratory two-variable Firth penalized logistic regression model (hemoglobin and lesion continuity) was fitted to 31 complete cases, with internal validation using 2000 bootstrap resamples. Results: = 0.032) compared to AC patients. Descriptively, multisegmental AC patients exhibited more severe ileocecal than distal lesions. Notably, 61.5% of AC patients were initially misdiagnosed as UC prior to definitive biopsy results. Despite a small sample size, an exploratory model integrating hemoglobin and continuity achieved an optimism-corrected AUC of 0.905 via internal bootstrap validation. Conclusion: Integrating hemoglobin and lesion continuity, alongside the inverted severity gradient, provides valuable clinical clues to distinguish AC from UC and guide targeted biopsies. Given the small sample size and lack of external validation, these exploratory findings require prospective confirmation in larger cohorts.

Source: Infection and Drug Resistance

DOI: 10.2147/idr.s643571