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DOI: 10.1055/s-0043-1770158
Images in Gastrointestinal Infections: Dual Infection of Enterobius vermicularis and Entamoeba histolytica in a Case with Bloody Diarrhea
A 27-year-old woman presented to the emergency department with chronic bloody diarrhea for 6 weeks. She had a stool frequency of five to seven per day. Her physical and per rectal examinations were normal. Investigations revealed anemia with hemoglobin of 9.7% and red blood cells in stool examination. Colonoscopy revealed a few ulcers in the cecum, ileocecal valve ([Fig. 1a]), and rectum ([Fig. 1b]). Histopathology examination of cecal biopsy revealed Enterobius vermicularis (pinworm; [Fig. 1c]). However, symptoms and endoscopic findings could not be explained by E. vermicularis alone. The biopsy and colonoscopy findings did not suggest inflammatory bowel disease. On careful histopathology slide review, trophozoites of Entamoeba histolytica were seen in cecal and rectal biopsy ([Fig. 1d]). The patient was treated with metronidazole, diloxanide furoate, and albendazole. The patient's symptoms improved. In this case, the clinical presentation was inconsistent with E. vermicularis infection, which was obvious in the initial examination. A few trophozoites of E. histolytica were discovered on diligent review of histopathology. This case highlights the importance of keeping broad differentials and reviewing all investigations when discordancy with a clinical profile exists.[1]
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Conflict of Interest
None declared.
Acknowledgment
None.
Ethical Statement
Not applicable for the images. Informed consent was taken from the patient.
Authors' Contribution
All the authors contributed equally to the article.
Data Availability Statement
There are no data associated with this work.
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References
- 1 Sethi S, Nayak HK, Panigrahi C, Patra S, Panigrahi MK, Samal SC. Double infection in Crohn's disease. Indian J Gastroenterol 2023; 42 (05) 731-733
Address for correspondence
Publication History
Received: 06 April 2023
Accepted: 13 May 2023
Article published online:
20 February 2024
© 2024. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Sethi S, Nayak HK, Panigrahi C, Patra S, Panigrahi MK, Samal SC. Double infection in Crohn's disease. Indian J Gastroenterol 2023; 42 (05) 731-733
![](https://www.thieme-connect.de/media/10.1055-s-00058266/202401/thumbnails/10-1055-s-0043-1770158-i23150120-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)