The Slipshod Stooge-Amoebic Colitis

Amoebic colitis occurs due to infection of gastrointestinal tract with protozoan parasite Entamoeba histolytica.The invasive amoebic trophozoites propagate through simple binary fission.Susceptibility to invasive amoebic infection is contingent to immune status of host.Morphological similarity of Entamoeba histolytica to Entamoeba dispar, Entamoeba moshkovskii, Entamoeba bangladeshi or Entamoeba nuttalli is encountered.Additionally designated as amoebiasis, amoebic trophozoites burrow through superimposed mucosa and invade submucosal tissue.Generally, implicated soft tissue is devoid of amalgamation of amoebic cysts [1,2].Typically, amoebic infection engenders flask shaped ulcers.Exceptionally, intestinal perforation or an inflammatory mass as an amoeboma may arise [1,2].Amoebic colitis can be specifically diagnosed with discernible parasitic trophozoites invading intestinal mucosa [1,2].Commonly encountered in tropical or subtropical regions, no geographical zone of infection with Entamoeba histolytica is exempt.Immigrants to developed countries, travellers, institutionalized subjects and men with sexual contact with men (MSM) are frequently infected.Incriminated males may recurrently exhibit disseminated infection.Amoebic colitis implicates colonic segments of large intestine as cecum, right colon, rectum, sigmoid or appendix.Cutaneous lesions may ensue.Terminal ileum is devoid of infiltration with parasitic trophozoites.Haematogenous dissemination commonly occurs into brain, hepatic or pulmonary parenchyma.Recto-vesical fistula or cutaneous fistula may be configured [1,2].Invasive infection of large intestine with Entamoeba histolytica is predominantly transmitted with ingestion of parasitic cysts through faecal contamination of food or water, thereby inducing faecal -oral route.Besides, sexual contact or oral-anal route may be articulated.Parasitic trophozoites may disseminate into hepatic parenchyma or associated viscera [1,2].Parasitic cysts are resistant to digestion by gastric acid or chlorinated water.Ex-cystation may occur within small intestine with consequent trophozoite dissemination and invasion of gastrointestinal tract.Discernible genetic polymorphisms within leptin receptor may alter host susceptibility to invasion with Entamoeba histolytica [1,2].