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An acute fulminant amoebic colits rarely develops as a complication of amoebiasis, and is difficult to diagnose and treat when it occurs. It is a life-threatening disease, and associated with a very high mortality rate. Herein, a case 42-old-year man, who had a generalized peritonitis caused by an acute fulminant amoebic colitis, is reported, with a review of the literature. He died of multiple organ failure, following sepsis and disseminated intravascular coagulation, on the 19th day after his operation, despite treatment with aggressive surgery and anti-amoebic agents. An emergency laparotomy should be considered when an acute fulminant amoebic colitis deteriorates despite the use of intensive anti-amoebic therapy, especially when there is an acute episode suggestive of perforation. A primary total resection of the diseased colon is one of the treatments of choice. (J Korean Surg Soc 2005;69:79-82)
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