Resembling inflammatory bowel disease: infectious causes of multiple colonic ulcers in children—three case reports and a literature review

With the increasing use of digestive endoscopy in children, the diagnostic rate of colonic ulcers has increased. Clarifying the underlying causes early, including ruling out infection and inflammatory bowel disease, is important to ensure timely diagnosis and treatment. This study retrospectively analyzed three pediatric patients presenting with gastrointestinal symptoms who were diagnosed with multiple colonic ulcers caused by Entamoeba histolytica , Epstein-Barr virus, and Salmonella Typhimurium, respectively. The main symptoms in all three children were abdominal pain and hematochezia. Colonoscopy revealed varying degrees of multiple colonic ulcers, and pathogen results confirmed that the ulcers were related to infection. Follow-up after targeted anti-infective treatment showed a significant improvement in the ulcers. Multiple colonic ulcers in children can be caused by infections, and timely diagnosis requires pathogen detection combined with clinical, endoscopic, and pathological findings, followed by targeted treatment.