A Case of Steroid Treated Amebic Colitis Misdiagnosed as Eosinophilic Colitis

호산구성 대장염으로 오인되어 스테로이드를 치료받은 아메바 결장염 1예

  • Cheong, Eun-Sun (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Jo, Yun-Ju (Department of Internal Medicine, Eulji University College of Medicine) ;
  • An, Sang-Bong (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Kim, Seong-Hwan (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Park, Young-Sook (Department of Internal Medicine, Eulji University College of Medicine) ;
  • Lee, Won-Mi (Department of Pathology, Eulji University College of Medicine) ;
  • Hong, Young-Ok (Department of Pathology, Eulji University College of Medicine)
  • 정은선 (을지대학교 의과대학 내과학교실) ;
  • 조윤주 (을지대학교 의과대학 내과학교실) ;
  • 안상봉 (을지대학교 의과대학 내과학교실) ;
  • 김성환 (을지대학교 의과대학 내과학교실) ;
  • 박영숙 (을지대학교 의과대학 내과학교실) ;
  • 이원미 (을지대학교 의과대학 병리학교실) ;
  • 홍영옥 (을지대학교 의과대학 병리학교실)
  • Published : 2011.07.30

Abstract

Some cases have reported that amebic colitis leads to serious complications that are caused by a misdiagnosis of an inflammatory bowel disease and consequential ill-managed steroid therapy. Therefore, it should be stressed that the differential diagnosis on such a case is very important. Eosinophilic colitis may reveal its presence as diarrhea, abdominal pain, ascites, and eosinophilic deposits in tissues. Therefore, it is highly necessary to make a differential diagnosis to distinguish eosinophilic colitis from other infectious or inflammatory bowel diseases. We report a case of amebic colitis, which was mistakenly diagnosed as eosinophilic colitis and a liver eosinophilic abscess in a young male who complained of bloody diarrhea and right upper quadrant pain. However, the misdiagnosed steroid therapy did not aggravate the progress of the amebic infection.

아메바 결장염은 위생 상태 및 상하수도 시설의 개선에 의해 국내에서의 유병률은 감소하고 있지만, 조직이나 분변에서 아메바가 발견되지 않으면 확진이 어려운 질환이다. 최근 아메바결장염이 염증성 장질환으로 오진되어 스테로이드 치료로 인해 합병증이 발생한 증례보고가 있어 감별 진단이 중요하다. 호산구 대장염은 설사, 복통, 복수 등 다양한 증상으로 발현하고 조직에서 호산구 침착이 관찰되어 다른 감염성 혹은 염증성 장질환과의 감별진단이 필요하다. 저자들은 혈성 설사, 우상복부 통증을 호소하는 젊은 남자에서 호산구 대장염과 호산구 간농양으로 오인되었던 아메바 결장염 증례를 보고한다. 이 환자에서 호산구 대장염으로 오진하여 사용했던 스테로이드가 아메바 감염증의 경과를 악화시키지는 않았다.

Keywords

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