A Patient with the Diagnosis of Ulcerative Colitis Presenting with Entamoeba histolytica and Strongyloides stercoralis Infection

Parasitic infections may be seen in ulcerative colitis patients. Strongyloides stercoralis is a nematode which causes opportunistic infection involving the small bowel. The stool of a patient diagnosed and treated as ulcerative colitis for the last four years was examined and trophozoite forms of E. histolytica were determined. Metronidazole and diloxanide furoate were prescribed and four months after he had been discharged from the hospital, ulcerative colitis relapsed. Stool examination was repeated and E. histolytica cyst and trophozoite forms were seen. This time secnidazole and tetracycline were given. During this therapy, cyst forms of E. histolytica and rabditiform larvae of S. stercoralis were seen in control fecal examination. Albendazole was added to the treatment for three days. In the microscopic examination of the stool which was repeated two months later, no parasite forms were detected. In literature, there were no articles reporting ulcerative colitis associated with amebiosis and strongyloidosis. These results suggest that parasitologic examination of stool is very important for the diagnosis and treatment of ulcerative colitis cases resistant to therapy