Abstract
A-55-year-old man visited a local hospital complaining of high fever, and antibiotics were administered. Because his fever persisted in spite of continuous antibiotic intervention, serum HIV antigen was checked and he proved to be infected with the HIV virus. For further examination and treatment, he was referred to the infectious disease department of our hospital. On the 10th day after admission, he began to complain of anal pain which got worse, and a perianal ulcer developed with bloody discharge. He was transferred to the surgical department for a colostomy to preserve the rest of his rectum. Pelvic CT revealed diffuse thickening of the wall of the rectum. Rectal bleeding was so severe that we performed pelvic angiography to achieve hemostasis before operation, but after the procedure hematochezia persisted. The rectal ulcer became aggravated, and skin tissue around the anus showed necrosis. We gave up preserving the anus and performed an abdominoperineal resection. The raw surface of the resected specimen showed necrotic black and yellowish white rectal mucosa. Pathological examination of the resected specimen showed trophozoite amoebae which led to a diagnosis of fulminating amoebic proctitis.
