Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review.
BACKGROUND:Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of th...
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ftdoajarticles:oai:doaj.org/article:485fa7e9bce34491a46503f897ae7e3d 2023-05-15T15:09:35+02:00 Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. Debbie-Ann Shirley Shannon Moonah 2016-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004879 https://doaj.org/article/485fa7e9bce34491a46503f897ae7e3d EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4965027?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004879 https://doaj.org/article/485fa7e9bce34491a46503f897ae7e3d PLoS Neglected Tropical Diseases, Vol 10, Iss 7, p e0004879 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004879 2022-12-31T01:04:29Z BACKGROUND:Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment. METHODOLOGY AND PRINCIPAL FINDINGS:Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery. CONCLUSIONS AND SIGNIFICANCE:Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 7 e0004879 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Debbie-Ann Shirley Shannon Moonah Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Amebic colitis, caused by intestinal infection with the parasite, Entamoeba histolytica, is a common cause of diarrhea worldwide. Fulminant amebic colitis is the most devastating complication of this infection, associated with both high mortality and morbidity. We conducted a review of the English literature to describe cases of fulminant amebic colitis associated with exposure to corticosteroid medications in order to identify the risk factors for poor outcome and determine difficulties in diagnosis and treatment. METHODOLOGY AND PRINCIPAL FINDINGS:Articles reporting severe and fulminant forms of amebic colitis between 1991 and 2016 were collected. 525 records were screened to identify 24 cases for qualitative analysis associated with corticosteroid use. Cases arose from areas of high endemicity or travel to such areas. Most cases (14 of 24, 58%) were given corticosteroids for initially misdiagnosed colitis, mainly inflammatory bowel, resulting in rapid progression of disease. Nearly half of all cases underwent surgical intervention, and 25% of cases died, despite all patients eventually receiving treatment with metronidazole. The odds of death did not differ significantly by prior misdiagnosis, co-morbidities, bowel perforation or need for surgery. CONCLUSIONS AND SIGNIFICANCE:Infection with E. histolytica should be considered prior to the administration of corticosteroids, in particular for patients residing in endemic areas or those with appropriate travel history, especially prior to the diagnosis of inflammatory bowel disease. The development of preventative and treatment interventions are needed to improve outcomes of fulminant disease. |
format |
Article in Journal/Newspaper |
author |
Debbie-Ann Shirley Shannon Moonah |
author_facet |
Debbie-Ann Shirley Shannon Moonah |
author_sort |
Debbie-Ann Shirley |
title |
Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
title_short |
Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
title_full |
Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
title_fullStr |
Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
title_full_unstemmed |
Fulminant Amebic Colitis after Corticosteroid Therapy: A Systematic Review. |
title_sort |
fulminant amebic colitis after corticosteroid therapy: a systematic review. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004879 https://doaj.org/article/485fa7e9bce34491a46503f897ae7e3d |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 7, p e0004879 (2016) |
op_relation |
http://europepmc.org/articles/PMC4965027?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004879 https://doaj.org/article/485fa7e9bce34491a46503f897ae7e3d |
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https://doi.org/10.1371/journal.pntd.0004879 |
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PLOS Neglected Tropical Diseases |
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e0004879 |
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