A rare case of an intestinal ulcer: AIDS and amebic colitis in a homosexual man with ulcerative colitis.

A 56-year-old man with half of year history of UC was admitted to our hospital due to abdominal pain, diarrhea, and hematochezia (more than ten times per day) for two weeks. He had had homosexual intercourse with many men. Subsequent laboratory findings revealed that there was a significant increase in elevated white blood cells (WBC, 11.77x109/L), C-Reactive Protein (CRP, 83.7 mg/L), tumor necrosis factor-alpha (TNF-ɑ, 6.83 pg/ml), interleukin-2 (IL-2, 75.78 pg/ml), IL-6 (124.68 pg/ml), IL-10 (58.24 pg/ml) and IL-17 (128.76 pg/ml), and fecal calprotectin (FC >1800 μg/g). Albumin (ALB, 22.5 g/L) and Hemoglobin (Hb, 98 g/L) were significantly decreased. Amoeba was identified in the stool. The abdominal contrast-enhanced Computed Tomography (CT) showed that there was thickened intestinal wall in the sigmoid colon and rectum. Colonoscopy and intestinal histopathology suggested active severe UC (E2) and Entamoeba Histolytica (trophozoites) in the necrotic tissue (Figure 1). The result of enzyme immunoassay (EIA) screening for HIV was positive. The HIV viral load was 7.85x109 copies/mL, and the CD4+ cell count was 43/μL.