Amebic colitis. Preventing morbidity and mortality from fulminant disease.

Uncomplicated amebic colitis is readily treated and has a mortality rate of less than 0.5%. Complications necessitating surgical intervention develop in only 6% to 11% of patients with symptomatic disease. However, the mortality rate in these patients ranges from 40% to 100% and stems in part from delays in diagnosis and treatment. Patients with known amebic colitis who show signs of systemic toxicity or of localized or generalized peritonitis are at high risk for complications; surgical consultation should be obtained. Patients who are thought to have acute appendicitis, diverticulitis, or obstructive or perforative carcinoma but have a history of dysentery atypical of that in these conditions should also be evaluated for amebiasis. Such patients should be treated presumptively until the diagnosis of amebic colitis can be excluded.