| Patients with either symptomatic or asymptomatic intestinal amebiasis treated with corticosteroid therapy are at high risk of developing the potentially fatal complication of fulminant amebic colitis. |
| Infection with E. histolytica should be considered prior to the diagnosis of inflammatory bowel disease, and for subsequent exacerbations. |
| Travel history of patients, their close house hold and sexual contacts should be obtained prior to initiation of systemic corticosteroids. Patients residing in or with travel history to endemic parts of the world, such as South and Southeast Asia, Africa, Central America, South America and Mexico, should be screened for amebiasis with tests that afford the highest level of sensitivity and specificity available. |
| All patients with evidence of E. histolytica infection should be treated appropriately prior to initiating corticosteroids to prevent fulminant amebic colitis. Amebic colitis should be treated with metronidazole followed by a luminal agent, such as paromomycin. Treatment with a luminal agent alone is sufficient for patients with asymptomatic intestinal amebiasis. |
| Research efforts are needed to develop both interventions to prevent amebic colitis, and additional therapies to treat fulminant amebic colitis are needed to improve outcomes. |
