title: Fulminant amebic colitis: analysis of 55 cases.
abstract: Fulminant amebic colitis is a rare disease with high morbidity and mortality.
  
  
  OBJECTIVE
  This study was designed to identify the most frequent clinical and histopathologic features of fulminant amebic colitis and to analyze results of surgical treatment and the existence of risk factors for mortality.
  
  
  METHODS
  A retrospective analysis was conducted of clinical and histopathologic data of 55 patients with fulminant amebic colitis. Data were obtained from the files of autopsies and surgical operations that had been performed at a referral center in Mexico from 1943 through 1994.
  
  
  RESULTS
  Median age was 52 (range, 18-79) years. There were 34 men (62 percent) and 21 women (38 percent). Diabetes mellitus and chronic alcoholism were the most frequent diseases in association with fulminant amebic colitis (40 and 31 percent, respectively). The most frequent clinical manifestations were abdominal pain, diarrhea, rectal bleeding, and fever. There was a coexistent amebic liver abscess in 54 percent of patients. The main histopathologic characteristics were necrosis, presence of trophozoites, and acute and/or chronic inflammation. Of 25 patients who underwent surgery, only six survived (operative mortality, 76 percent; overall mortality, 89 percent). The variables that correlated with mortality were longer duration of symptoms, lower count of leukocytes, nonsurgical treatment, nonresective surgical procedure, hospital admission before 1971, and invasion of trophozoites into or through the muscularis.
  
  
  CONCLUSIONS
  The results may help to obtain an earlier diagnosis and establish proper treatment of fulminant amebic colitis.
authors.affiliation: Department of Surgery, Instituto Nacional de la Nutricion Salvador Zubiran, Mexico City, Mexico.
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: A
authors.initials: A
authors.lastname: Gamboa-Dominguez
authors.forename: T J
authors.initials: TJ
authors.lastname: Gomez-Mendez
authors.forename: J M
authors.initials: JM
authors.lastname: Remes
authors.forename: V
authors.initials: V
authors.lastname: Rembis
authors.forename: D
authors.initials: D
authors.lastname: Martinez-Gonzalez
authors.forename: J
authors.initials: J
authors.lastname: Gutierrez-Saldivar
authors.forename: J C
authors.initials: JC
authors.lastname: Morales
authors.forename: J
authors.initials: J
authors.lastname: Granados
authors.forename: J
authors.initials: J
authors.lastname: Sierra-Madero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D004404:Dysentery, Amebic / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000150:complications; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors