In vivo visualization of trophozoites in patients with amoebic colitis by using a newly developed endocytoscope

Background: The endocytoscopy system (ECS) is a new method to provide real-time super-magnifying microscopic imaging in vivo. Routine diagnosis of amebic colitis requires multiple tests that are both time consuming and costly. Objective: To determine the feasibility of ECS to directly detect the amebic parasites in vivo. Design: Prospective, single-center, pilot study. Setting: Tertiary-care university hospital. Patients: This study involved 5 patients who were suspected to have amebic colitis by conventional colonoscopy in our institute. Interventions: A super-magnifying ECS with 450 × magnification. Main Outcome Measurements: We compared ECS findings with those of conventional methodsserum antibody tests and histology of colon biopsy specimens. Results: We successfully visualized the amebic trophozoites in all 5 cases. In contrast, 3 specimens had positive results on serology, and 3 had positive histology results on hematoxylin and eosin staining. Limitations: Pilot study with a limited number of patients. Findings were compared only with serology and histology findings. Conclusions: ECS would be a useful tool for the prompt diagnosis of amebic colitis via the real-time in vivo visualization of amebic trophozoites.