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:
Severe bacterial infection
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.