title: Amoebic toxic colitis: analysis of factors related to mortality.
abstract: BACKGROUND
  Toxic or fulminant colitis due to Entamoeba histolytica infrequently presents but is very serious. Unfortunately, there are numerous contradictory factors related to mortality.
  
  
  METHODS
  We analyzed several cases of E. histolytica infection  to determine the factors related to mortality. We included patients >15 years of age who were histopathologically diagnosed with amoebic toxic colitis and treated from January 2000 through December 2006. We evaluated demographic, clinical, laboratorial, surgical, and histopathological characteristics.
  
  
  RESULTS
  We examined 24 patients and recorded 12 deaths (50%). Twenty patients underwent surgery within a mean time of 24 hours (range: 8-120 hours). Tenesmus and intestinal perforation were determined to be statistically significant (P<0·05) by univariate analysis. Three models  of logistic regression were able to determine three statistically significant factors that affected mortality: (1) tenesmus and a lymphocyte count <1·5×10(3) cell/μl; 2) depth of invasion beyond the mucosa and a lymphocyte count <1·5×10(3)  cell/μl; 3) time spent with symptoms and perforation.
  
  
  CONCLUSIONS
  The mortality rate determined in this study is similar to previously reported series. A low lymphocyte count, significant depth of invasion, and intestinal perforation were determined to be the factors related  to increased mortality, while tenesmus and limited amount of time spent with symptoms were associated with survival. Quick diagnosis and appropriate treatment are important factors that reduce mortality.
authors.affiliation: General Surgery Department, Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, México.
authors.forename: Fátima
authors.initials: F
authors.lastname: Ortiz-Castillo
authors.forename: Luis Enrique
authors.initials: LE
authors.lastname: Salinas-Aragón
authors.forename: Martín
authors.initials: M
authors.lastname: Sánchez-Aguilar
authors.forename: J Humberto
authors.initials: JH
authors.lastname: Tapia-Pérez
authors.forename: Martín
authors.initials: M
authors.lastname: Sánchez-Reyna
authors.forename: Mauricio
authors.initials: M
authors.lastname: Pierdant-Pérez
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Sánchez-Rodríguez
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Hernández-Sierra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004404:Dysentery, Amebic / Q000150:complications / Q000276:immunology / Q000401:mortality* / Q000473:pathology*; D004748:Entamoeba histolytica / Q000472:pathogenicity*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000401:mortality; D008231:Lymphopenia / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult