INTRACTABLE AMEBIC COLITIS: WITH SPECIAL REFERENCE TO THE ULCERONECROTIC FORM

Amebiasis is far more prevalent in the United States than is generally appreciated. Although areas of hyperendemicity, such as are present in the Orient and tropics, are not found in this country, the states bordering the Gulf of Mexico may be generally considered as comprising an endemic area, and sporadic cases have been observed over the entire country. In New Orleans alone it has been estimated that the protozoon is harbored by close to 15 per cent of the general population. Most of these cases are symptomatically below the clinical threshold. Amebic colitis exists as a pathologic entity without the classic picture of dysentery in a high percentage of the cases. Liver abscess, percentage wise, is relatively rare. The symptomatology varies from mild, rare, abdominal discomfort and constipation to acute abdominal pain of the most extreme degree and uncontrollable diarrhea; the duration may range from a few days to many