Recent travel with alternating constipation and diarrhea, colitis, abdominal pain, fever, weight loss. Which disease is likely?

Recent travel with alternating constipation and diarrhea, colitis, abdominal pain, fever, weight loss. Which disease is likely?

• A. Giardiasis
• B. Amebiasis
• C. Strongyloidiasis
• D. Ascariasis

Answer: (B)

The pattern comes from an invasive intestinal infection acquired during travel that inflames the colon and can cause systemic symptoms. Entamoeba histolytica, the parasite responsible for amebiasis, penetrates the colonic mucosa and produces colitis with abdominal pain, fever, and weight loss. The inflammation can disrupt normal bowel function, leading to alternating diarrhea and constipation as the mucosa becomes edge-padded with ulcers and edema. Travel to areas with contaminated water or food is a classic risk, and fever plus weight loss plus colitis-like symptoms fit this picture well. Giardiasis typically causes foul-smelling, greasy diarrhea with bloating and malabsorption, and fever is not common. Strongyloidiasis can cause abdominal pain and diarrhea but often features eosinophilia and may present with distinctive skin findings or in more severe disseminated forms, especially in immunocompromised individuals. Ascariasis usually presents with intermittent GI symptoms or obstruction but not a classic febrile colitis pattern.

The pattern comes from an invasive intestinal infection acquired during travel that inflames the colon and can cause systemic symptoms. Entamoeba histolytica, the parasite responsible for amebiasis, penetrates the colonic mucosa and produces colitis with abdominal pain, fever, and weight loss. The inflammation can disrupt normal bowel function, leading to alternating diarrhea and constipation as the mucosa becomes edge-padded with ulcers and edema. Travel to areas with contaminated water or food is a classic risk, and fever plus weight loss plus colitis-like symptoms fit this picture well.

Giardiasis typically causes foul-smelling, greasy diarrhea with bloating and malabsorption, and fever is not common. Strongyloidiasis can cause abdominal pain and diarrhea but often features eosinophilia and may present with distinctive skin findings or in more severe disseminated forms, especially in immunocompromised individuals. Ascariasis usually presents with intermittent GI symptoms or obstruction but not a classic febrile colitis pattern.