Document Detail


Amoebic toxic colitis: analysis of factors related to mortality.
MedLine Citation:
PMID:  23265426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Fátima Ortiz-Castillo; Luis Enrique Salinas-Aragón; Martín Sánchez-Aguilar; J Humberto Tapia-Pérez; Martín Sánchez-Reyna; Mauricio Pierdant-Pérez; José Juan Sánchez-Rodríguez; Juan Francisco Hernández-Sierra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pathogens and global health     Volume:  106     ISSN:  2047-7732     ISO Abbreviation:  Pathog Glob Health     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-12-25     Completed Date:  2013-05-29     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  101583421     Medline TA:  Pathog Glob Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  245-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Dysentery, Amebic / complications,  immunology,  mortality*,  pathology*
Entamoeba histolytica / pathogenicity*
Female
Humans
Intestinal Perforation / diagnosis,  mortality
Lymphopenia / diagnosis,  mortality
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Analysis
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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