Correspondence
Case 31-1998: A Boy with Bronchiectasis
N Engl J Med 1999; 340:738March 4, 1999
- Article
To the Editor:
The patient described in Case Record 31-1998 (Oct. 15 issue),1 an eight-year-old boy with bronchiectasis, was born in El Salvador. Examination of stool specimens showed ova of Ascaris lumbricoides and cysts of Entamoeba coli. Ent. coli does not usually invade host tissues and usually can be recovered in the feces of people without symptoms. Ent. histolytica is the only pathogenic ameba of the genus entamoeba; it causes ulcers in the large intestine and can subsequently invade the liver and other tissues (mainly the lungs and the central nervous system). In the differential diagnosis, we would have discarded the hypothesis of amebic pulmonary abscess, not because the patient had a normal erythrocyte sedimentation rate and a normal liver on computed tomography, but because Ent. coli does not cause such a pathologic condition in the lungs.
1 ReferencesStefano Novati, M.D.
Antonella Bruno, Sc.D.
Guido Chichino, M.D.
IRCCS Policlinico San Matteo, 27100 Pavia, Italy1
Case Records of the Massachusetts General Hospital (Case 31-1998)
Full Text | Web of Science | Medline
Author/Editor Response
Dr. Cleveland replies:
To the Editor: I thank Novati et al. for their comments concerning epidemiologic reasons for excluding parasitic infestation as a likely cause of the bronchiectasis in this case. From an imaging perspective, the observations of lung disease, which, as discussed, was atypical of disease caused by amebae, and the absence of a liver abscess on the computed tomographic scan also were helpful in ruling out Ent. coli.
Robert H. Cleveland, M.D.
Children's Hospital, Boston, MA 02115- Citing Articles (1)
Citing Articles
1
E Scott Sills, Michael J Tucker, Gianpiero D Palermo. (2000) Assisted reproductive technologies and monozygous twins: implications for future study and clinical practice. Twin Research and Human Genetics 3:4, 217-223
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