Erythrophagocytosis in colonic mucosa: real-time amazing dis
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A 42-year-old man presented with a history of episodic painless lower gastrointestinal (GI) bleeds for 10 days. He passed approximately 200–300?mL maroon colored blood in each episode. There was no history of fever, anorexia, weight loss or abdominal lump. History of use of Non-Steroidal Anti Inflammatory Drug (NSAID) was present. Physical examination showed marked pallor. His hemoglobin was 53?g/L and TLC was 12 400/mm3. The patient was resuscitated and underwent a blood transfusion. Colonoscopy revealed multiple discrete 3–8?mm size raised lesions with overlying ulceration clustered in the cecum.

The ulcer was covered with whitish exudate and had a surrounding reddish halo. The exudate scraping was immersed in saline and visualized in real-time. Light microscopy showed a few motile amoebic trophozoites with ingested RBCs within. Histopathology showed mucosal ulceration, inflammatory granulation tissue with exudation, enterohemorrhagic debris, and numerous amoebic trophozoites with ingested RBCs following which he was started on metronidazole for 2 weeks and he achieved complete clinical response. Repeat colonoscopy performed 2?weeks later showed significant healing.

Source:https://casereports.bmj.com/content/13/12/e238921
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