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Image Based Question – 74477

Question

A 23 years old male presented with abdominal pain and bloody diarrhea of one-week duration. The follo­wing colonoscopic biopsy is diagnostic of infection with:

A. Amoebiasis

B. Enterobius

C. Giardiasis

D. Severe bacterial infection

 

Show Answer

Correct Answer » A

Explanation

Ans: A. Amoebiasis

(Ref: Paniker’s 7/e p17; Jawetz 27/e p711; Harrison 19/e p1364)

  • History of abdominal pain and bloody diarrhea of one-week duration and the given colonoscopic biopsy, appearance of ulcers on colonoscopy inflammatory infiltrate with Entamoeba histolytica trophozoites is diagnostic of amoebiasis.
  • The earliest intestinal lesions are microukerations of the mucosa of the cecum, sigmoid colon, or rectum that release erythrocytes, inflammatory cells, and epithelial cells.
  • Proctoscopy reveals small ulcers with heaped-up margins and normal intervening mucosa.
  • Submucosal extension of ulcerations under viable-appearing surface mucosa causes the classic “flask-shaped” ulcer containing trophozoites at the margins of dead and viable tissues.
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