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After an initial febrile viral syndrome, infection with Ebola virus often induces an explosive late “Ebola sepsis-like syndrome” which appears very similar to some phenotypes of bacterial sepsis and is commonly fatal. It is possible that direct and diffuse viral infection of both the endothelium and epithelium of the colon may cause sufficient disruption of both the endothelial and epithelial barriers to induce exposure or leakage of endotoxin and bacterial antigens to, or into, the vascular system precipitating or exacerbating the Ebola sepsis-like syndrome. If colonic barrier disruption or vascular exposure of bacterial antigens from the colon is found to comprise an important mechanism of the Ebola sepsis-like syndrome, protocolized timed decontamination of the bowel with or without timed prophylactic antibiotics might warrant investigation.   Electronic supplementary material  The online version of this article (doi:10.1186/s13037-014-0048-z) contains supplementary material, which is available to authorized users.

Combined endothelial and epithelial barrier disruption of the colon may be a contributing factor to the Ebola sepsis-like syndrome