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Fulminant colitis is a severe and potentially life-threatening form of associated bacterial disease leading to inflammation and damage to the colon. Complications such as toxic megacolon, sepsis, and multi-organ failure commonly occur in individuals with compromised immune systems and recent antibiotic use. Management of colitis involves optimization of fluid and electrolyte balance, and elimination of bacteria commonly by administering vancomycin or fidaxomicin.

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In recent years, there has been a significant rise in both the frequency and severity of colitis. This infection presents a broad clinical spectrum, ranging from asymptomatic colonization to severe fulminant colitis, which often requires urgent surgical intervention. The failure of medical treatments and the development of toxic megacolon typically necessitate surgery, though it is associated with high mortality rates.

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Fulminant amoebic colitis: a challenging diagnosis for the surgeon.

J Surg Case Rep

November 2024

Department of General and Endoscopic Surgery, Dr. Manuel Gea González General Hospital, Calzada de Tlalpan 4800, Belisario Domínguez Sección XVI, Mexico City 14080, Mexico.

Fulminant amoebic colitis is a rare complication of amoebiasis that carries a high mortality rate. Its diagnosis is challenging and requires a high index of suspicion, and its early recognition is a priority to provide timely medical and surgical treatment. We present the case of a male patient who came to the emergency department with unspecific clinical presentation of abdominal pain, systemic inflammatory response and imaging study showing intestinal perforation of the right colon.

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In recent years, tofacitinib has been used in patients with acute severe ulcerative colitis (ASUC) as a rescue therapy with encouraging success rates. We present details of four patients with steroid-refractory ASUC treated with tofacitinib. All the patients were biologics-naive.

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Amoebic colitis, a parasitic infection caused by , can lead to severe gastrointestinal symptoms. The clinical manifestations can vary widely, from being an asymptomatic carrier to experiencing severe colitis and even colonic perforation. Surgical treatment for fulminant amoebic colitis and colonic perforation should be carried out at the earliest.

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