The most frequent cause of pseudomembranous colitis is Clostridium difficile(C.difficile) infection.This type of colitis is characterized by an endoscopic pattern of numerous small,yellowish or whitish plaques diffuse...The most frequent cause of pseudomembranous colitis is Clostridium difficile(C.difficile) infection.This type of colitis is characterized by an endoscopic pattern of numerous small,yellowish or whitish plaques diffusely distributed,which typically compromises the rectum extending to proximal colon.Occasionally,the pseudomembranes compromise only the transverse or right colon,but their exclusive localization over polyps has not been reported.In this case report we have described a patient with symptoms compatible with C.difficile infection and positive for C.difficile toxigenic culture.Colonoscopy examination showed two small polyps with a whitish surface,and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas.The rest of the colonic mucosa was normal and no other cause was demonstrated.We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C.difficile and/or its toxins.展开更多
Clostridium difficile (CD), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or Crohn’s disease. Typical evid...Clostridium difficile (CD), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or Crohn’s disease. Typical evidence of colonic changes with CD infection, including pseudomembranous exudate, are often not present; however, a severe clinical course may result, including precipitation of toxic colitis and toxic megacolon. Recently, hypervirulent CD strains have been reported raising concern for a more severe disease process in patients with underlying inflammatory bowel disease.Moreover, small bowel involvement or CD enteritis has been increasingly described, usually in those with a history of a prior colectomy or total proctocolectomy for prior severe and extensive inflammatory bowel disease. Finally, refractory or treatment-resistant pouchitis may occur with CD infection.展开更多
文摘The most frequent cause of pseudomembranous colitis is Clostridium difficile(C.difficile) infection.This type of colitis is characterized by an endoscopic pattern of numerous small,yellowish or whitish plaques diffusely distributed,which typically compromises the rectum extending to proximal colon.Occasionally,the pseudomembranes compromise only the transverse or right colon,but their exclusive localization over polyps has not been reported.In this case report we have described a patient with symptoms compatible with C.difficile infection and positive for C.difficile toxigenic culture.Colonoscopy examination showed two small polyps with a whitish surface,and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas.The rest of the colonic mucosa was normal and no other cause was demonstrated.We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C.difficile and/or its toxins.
文摘Clostridium difficile (CD), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or Crohn’s disease. Typical evidence of colonic changes with CD infection, including pseudomembranous exudate, are often not present; however, a severe clinical course may result, including precipitation of toxic colitis and toxic megacolon. Recently, hypervirulent CD strains have been reported raising concern for a more severe disease process in patients with underlying inflammatory bowel disease.Moreover, small bowel involvement or CD enteritis has been increasingly described, usually in those with a history of a prior colectomy or total proctocolectomy for prior severe and extensive inflammatory bowel disease. Finally, refractory or treatment-resistant pouchitis may occur with CD infection.
