Fulminant amoebic colitis during chemotherapy for advanced gastric cancer.
A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently, peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved. However, the patient's general condition worsened with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.
Hanaoka
Noboru
N
Department of Gastroenterology, Kitasato University School of Medicine, 2-1-1 Asamizodai, Sagamihara-City, Kanagawa 228-8520, Japan. hanaoka-no@mc.pref.osaka.jp
Higuchi
Katsuhiko
K
Tanabe
Satoshi
S
Sasaki
Tohru
T
Ishido
Kenji
K
Ae
Takako
T
Koizumi
Wasaburo
W
Saigenji
Katsunori
K
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D004404:Dysentery, Amebic / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology*; D013274:Stomach Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology
D000970:Antineoplastic Agents; D000981:Antiprotozoal Agents; D008795:Metronidazole