Клинический случай пенетрирующей формы болезни Крона: трудности дифференциальной диагностики с амебиазом кишечника: КЛИНИЧЕСКИЙ СЛУЧАЙ

Елизавета Денисовна  Воронкова; Татьяна Викторовна  Габрусская; Елена Александровна  Корниенко; Наталья Борисовна  Уланова; Софья Геннадьевна  Килина; Елена Вадимовна  Шилова; Наталья Валерьевна  Павлова; Светлана Николаевна  Дроздова

doi:10.56871/PED.2026.92.25.010

A clinical case of the penetrating form of Crohn's disease: difficulties in differential diagnosis with intestinal amoebiasis

CLINICAL CASE

Е lizaveta D. Voronkona Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0008-1882-686X
Tatiana V. Gabrusskaya Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-7931-2263
Elena A. Kornienko Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-2743-1460
Natalya B. Ulanova Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-1262-4681
Sofia G. Kilina Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0001-3562-6412
Elena V. Shilova Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0003-2487-0783
Natalia V. Pavlova Saint Petersburg State Pediatric Medical University https://orcid.org/0000-0002-0661-6477
Svetlana N. Drozdova Saint Petersburg State Pediatric Medical University https://orcid.org/0009-0009-2163-4778

Keywords:

intestinal amoebiasis amoebic dysentery amoeboma differential diagnosis Crohn's disease penetrating form immunobiological therapy амебиаз кишечника амебная дизентерия амебома дифференциальная диагностика болезнь Крона пенетрирующая форма иммунобиологическая терапия

Abstract

The article presents a clinical case of penetrating form of Crohn's disease in a 16-year-old boy, who was previously diagnosed with chronic intestinal amoebiasis and received specific treatment. Despite the treatment, the disease progressed and led to complications such as necrosis and perforation of the cecal dome leading to surgical intervention. The diagnosis of intestinal amebiasis in this patient was made based on the clinical presentation of colitis and detection of cysts and vegetative forms of Entamoeba histolytica through fecal microscopy. Despite the severe and recurrent nature of the disease, other diagnostic methods for amebiasis, such as fecal polymerase chain reaction, were not performed in this case. The revision of the diagnosis towards the penetrating form of Crohn's disease, with the exclusion of an infectious process, including amoebiasis, led to change in the patient's management and allowed to achieve stable remission of the disease. This case demonstrates the complexity of differential diagnosis of diseases such as Crohn's disease and intestinal amoebiasis. It highlights the importance of an interdisciplinary approach and the use of highly specific laboratory diagnostic methods. This approach can help reduce the time it takes to make a diagnosis and prevent complications, improving the prognosis of the disease.

Author Biographies

Е lizaveta D. Voronkona, Saint Petersburg State Pediatric Medical University

Resident Doctor, Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University; address:
2 Litovskaya str., Saint Petersburg, 194100, Russia

Tatiana V. Gabrusskaya, Saint Petersburg State Pediatric Medical University

MD, Ph D, Pediatrician-Gastroenterologist, Associate Professor of the Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Elena A. Kornienko, Saint Petersburg State Pediatric Medical University

MD, Ph D, Dr Med Sci, Professor of the Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Natalya B. Ulanova, Saint Petersburg State Pediatric Medical University

gastroenterologist, Head of the Gastroenterology Department, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Sofia G. Kilina, Saint Petersburg State Pediatric Medical University

gastroenterologist, Department of Gastroenterology, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Elena V. Shilova, Saint Petersburg State Pediatric Medical University

Pediatrician-Gastroenterologist,
Department of Gastroenterology, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Natalia V. Pavlova, Saint Petersburg State Pediatric Medical University

MD, Ph D, Assistant Professor,
Professor M.G. Danilevich Department of Infectious Diseases in Children, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Svetlana N. Drozdova, Saint Petersburg State Pediatric Medical University

MD, Ph D, Associate Professor of the Department of Pediatrics named after Professor I.M. Vorontsov Faculty of Postgraduate and Continuing Professional Education, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

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