Sir.—Entamoeba histolytica can be responsible for a wide range of clinical conditions, varying in severity from the asymptomatic carrier state to fulminant colitis.1 Its role in causing chronic proctitis in children is less commonly appreciated. We present two children who developed painless rectal bleeding without diarrhea as the presenting symptom of chronic proctitis due to E histolytica.
Patient Reports.—Patient 1.—An 8-year-old Hispanic boy developed rectal bleeding 1 month after returning from a 6-month stay in Mexico. He had no diarrhea, abdominal pain, fever, tenesmus, or mucus in his stools.
Two weeks after the onset of painless hematochezia, results of the physical examination were normal, as were the hemoglobin, hematocrit, and white blood cell counts. Stool examinations for ova, parasites, and leukocytes had negative findings, and bacterial culture of the stool revealed no pathogens. A single-contrast barium examination of the colon showed it to be normal. During colonoscopy,