Investigation of Entamoeba histolytica and Mycobacterium spp. in biopsy specimens of patients with inflammatory bowel disease in Turkey

Abstract

Intestinal amebiasis and gastrointestinal tuberculosis can mimic inflammatory bowel disease and its
exacerbations clinically, pathologically, radiologically and endoscopically. In the existence of IBD
and/or either one of these two pathogens, early identification and prompt treatment can improve the
clinical course of the patients. The aim of this study was to investigate the presence of Entamoeba
histolytica and/or Mycobacterium spp. in the first diagnostic biopsy specimens of prediagnosed IBD
patients in a tertiary education hospital in Ankara, Turkey. As the differentiation of pathologic
Entamoeba histolytica must be based on isoenzymatic, immunologic or molecular analysis and PCR is
a rapid and reliable method for the identification of Mycobacterium spp., we investigated the presence
of these pathogens in the biopsy specimens of 20 patients who were suspected to have IBD and nine
controls, by using PCR-based detection methods. All of them were histopathologically diagnosed as
Crohn’s disease and none of the specimens contained these two pathogens. We thought that the low
prevalence of both infections in Crohn’s disease patients may have caused our negative findings and
loss of pathogens could have lowered the sensitivity. Further studies with larger number of patients are
needed to determine the misdiagnosis rate and coexistence of these three diseases.