DIAGNOSES AND DISCUSSION OF CHALLENGING CLINICAL CASE NO. 03/2001
Pseudomembranous (antibiotic-associated) colitis
| Sigmoidoscopic
demonstration of ahyperemic mucosa studded with plaquelike lesions is
characteristic of pseudomembranous (antibiotic-associated) colitis, which
is caused by the enterotoxin of Clostridium
difficile. Although
symptoms commonly develop while the offending antibiotic is still being
taken, the syndrome may not become evident until several days or weeks
after completion of therapy, Ischemic colitis may cause bloody diarrhea
but not the mucosal lesions described. Amebic or Shigella infestation is
associated with punched-out ulcerations of the mcosa. Toxic megacolon is a
cpmplication of active
colitis.s Treatment is directed at either
binding the toxin (cholestyramine) or eradicating the bacteria
(oral vancomycin or metronidazole). |