Elderly-onset Fulminant Amoebic Colitis Rescued with Conservative Treatment

Abstract

A 77-year-old man was admitted to our hospital with persistent watery diarrhea. Computed tomography revealed widespread intestinal inflammation, suggesting infectious enteritis. Symptoms did not improve after initiation of empiric levofloxacin which was further broadened to meropenem and fosfomycin and he developed toxic megacolon. After a detailed inquiry, we confirmed the history of sexual activity in a brothel several months before the onset. Suspecting fulminant amoebic colitis, metronidazole was started, and the symptoms improved markedly. Additional tests revealed a definite diagnosis of amoebic colitis. After that, he was discharged from the hospital without recurrence of colitis.
Even in the elderly, amoebic colitis should be considered one of differential diagnosis of enteritis. In addition, in fulminant amoebic colitis, conservative treatment may be effective, as our case. However, surgery should be considered immediately in those who fail to respond to medical management or if the complication such as perforation develops.