A case of amoebic proctitis misdiagnosed as ulcerative proctitis

CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES ›› 2025, Vol. 43 ›› Issue (6): 877-880.doi: 10.12140/j.issn.1000-7423.2025.06.021

• CASE REPORT • Previous Articles    

A case of amoebic proctitis misdiagnosed as ulcerative proctitis

ZHENG Huazhen1(), WANG Ziqi1, JIANG Hongye1, WU Xiaodan2, ZHENG Huijie1,*()   

  1. 1 Department of Clinical Laboratory, The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan 528000, Guangdong, China
    2 College of Medical Technology, Guangdong Medical University, Dongguan 523808, Guangdong, China
  • Received:2025-08-09 Revised:2025-11-11 Online:2025-12-30 Published:2025-12-26
  • Contact: *E-mail:841203529@qq.com
  • Supported by:
    National Natural Science Foundation of China Youth Program(82202570);Foshan “14th Five-Year Plan” High-Level Medical Key Specialty(202201010265);Foshan Science and Technology Bureau Technological Innovation Project(2320001006781)

Abstract:

This article reports a case of a 59-year-old female patient presenting with hematochezia and lower abdominal pain. Colonoscopy revealed rectal ulcers, and histopathology showed acute inflammation, leading to an initial diagnosis of ulcerative proctitis. After one month of standard anti-inflammatory therapy without clinical improvement, the diagnosis was revised to amoebic proctitis through stool microscopy combined with targeted next-generation sequencing (tNGS). The patient showed rapid symptomatic relief following anti-amebic treatment. This case highlights the diagnostic challenges of Entamoeba histolytica proctitis, including nonspecific clinical manifestations, endoscopic and pathological findings lacking specificity, and the limited sensitivity of conventional pathogen detection methods. For patients with treatment-refractory intestinal ulcers, molecular diagnostic techniques should be actively employed to improve diagnostic accuracy and prevent misdiagnosis and inappropriate treatment.

Key words: Entamoeba histolytica, Ulcerative proctitis, Targeted next-generation sequencing, misdiagnosis

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