Year 2022 / Volume 114 / Number 12
Letter
A rare case of an intestinal ulcer: AIDS and amebic colitis in a homosexual man with ulcerative colitis

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DOI: 10.17235/reed.2022.8903/2022

Cong Dai, Ying Wen,

Abstract
A 56-year-old man with half of year history of UC was admitted to our hospital due to abdominal pain, diarrhea, and hematochezia (more than ten times per day) for two weeks. He had had homosexual intercourse with many men. Subsequent laboratory findings revealed that there was a significant increase in elevated white blood cells (WBC, 11.77x109/L), C-Reactive Protein (CRP, 83.7 mg/L), tumor necrosis factor-alpha (TNF-ɑ, 6.83 pg/ml), interleukin-2 (IL-2, 75.78 pg/ml), IL-6 (124.68 pg/ml), IL-10 (58.24 pg/ml) and IL-17 (128.76 pg/ml), and fecal calprotectin (FC >1800 μg/g). Albumin (ALB, 22.5 g/L) and Hemoglobin (Hb, 98 g/L) were significantly decreased. Amoeba was identified in the stool. The abdominal contrast-enhanced Computed Tomography (CT) showed that there was thickened intestinal wall in the sigmoid colon and rectum. Colonoscopy and intestinal histopathology suggested active severe UC (E2) and Entamoeba Histolytica (trophozoites) in the necrotic tissue (Figure 1). The result of enzyme immunoassay (EIA) screening for HIV was positive. The HIV viral load was 7.85x109 copies/mL, and the CD4+ cell count was 43/μL.
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References
1. Hung CC, Chen PJ, Hsieh SM, Wong JM, Fang CT, Chang SC, Chen MY. Invasive amoebiasis: an emerging parasitic disease in patients infected with HIV in an area endemic for amoebic infection. AIDS 1999;13:2421-8.
2. Mitarai S, Nagai H, Satoh K, Hebisawa A, Shishido H. Amebiasis in Japanese homosexual men with human immunodeficiency virus infection. Intern Med 2001;40:671-5.
3. Skamnelos A, Tatsioni A, Katsanos KH, Tsianos V, Christodoulou D, Tsianos EV. CD4 count remission hypothesis in patients with inflammatory bowel disease and human immunodeficiency virus infection: a systematic review of the literature. Ann Gastroenterol 2015;28:337-346.
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Dai C, Wen Y. A rare case of an intestinal ulcer: AIDS and amebic colitis in a homosexual man with ulcerative colitis. 8903/2022


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Publication history

Received: 03/05/2022

Accepted: 06/05/2022

Online First: 24/05/2022

Published: 12/12/2022

Article Online First time: 21 days

Article editing time: 223 days


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