Intestinal Amoebiasis in Patients with Inflammatory Bowel Disease (IBD)

Introduction: Intestinal amoebiasis is defined as the condition in which the human body harbors Entamoeba histolytica, with or without clinical manifestations. It may mimic a flare-up of inflammatory bowel disease (IBD), particularly in endemic regions, potentially leading to diagnostic and therapeutic errors. A properly performed stool parasitological examination (SPE) is essential for establishing the diagnosis and preventing complications. Objective: To assess the prevalence of intestinal amoebiasis in patients with IBD and highlight the importance of stool parasite examinations (SPE) in the differential diagnosis of an IBD flare-up. Materials and methods: This were a retrospective study conducted at the Parasitology-Mycology Laboratory of the Hassan II University Hospital in Fez from August 2016 to December 2025. It covered all requests for SPE originating from the Gastroenterology-Hepatology Department for patients with IBD. Results: Out of 249 stool examinations performed, 67 were positive, representing a positivity rate of 27%. Crohn's disease affected 17 patients (25.37%), and ulcerative colitis affected 50 (74.63%). Male patients accounted for 52.22% of cases, and female patients for 44.78%. The *Entamoeba histolytica*/*E. dispar* complex was found in the vegetative form in 38.80% of cases and in the cystic form in 61.19%. Associated non-pathogenic intestinal parasites were found in 61.19% of cases. Conclusion: Screening for intestinal amoebiasis in patients with IBD is essential—particularly before initiating corticosteroid or immunosuppressive therapy—to avoid exacerbating an undiagnosed infection and to tailor therapeutic management.