scholarly journals Pseudomembranous Colitis: Not Always Caused byClostridium difficile

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Derek M. Tang ◽  
Nathalie H. Urrunaga ◽  
Hannah De Groot ◽  
Erik C. von Rosenvinge ◽  
Guofeng Xie ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Bowel Disease ◽  
Pseudomembranous Colitis ◽  
Collagenous Colitis ◽  
Mucosal Injury ◽  
Chronic Ischemia ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Inflammatory Bowel

Although classically pseudomembranous colitis is caused byClostridium difficile, it can result from several etiologies. Certain medications, chemical injury, collagenous colitis, inflammatory bowel disease, ischemia, and other infectious pathogens can reportedly cause mucosal injury and subsequent pseudomembrane formation. We present the case of a middle-aged woman with vascular disease who was incorrectly diagnosed with refractoryC. difficileinfection due to the presence of pseudomembranes. Further imaging, endoscopy, and careful histopathology review revealed chronic ischemia as the cause of her pseudomembranous colitis and diarrhea. This case highlights the need for gastroenterologists to consider non-C. difficileetiologies when diagnosing pseudomembranous colitis.

scholarly journals Sulphasalazine-Induced Pseudomembranous Colitis

1991 ◽  
Vol 5 (5) ◽  
pp. 167-170 ◽  
Author(s):  
Hugh J Freeman ◽  
Urs P Steinbrecher ◽  
WC Peter Kwan ◽  
Stephanie Ensworth
Keyword(s):  
Inflammatory Bowel Disease ◽  
Abdominal Pain ◽  
Ankylosing Spondylitis ◽  
Clostridium Difficile ◽  
Bowel Disease ◽  
Pseudomembranous Colitis ◽  
Flexible Sigmoidoscopy ◽  
Frequent Use ◽  
Toxin Assay ◽  
Inflammatory Bowel

An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive forClostridium difficile; andC difficiletoxin assay was positive. Despite the frequent use of sulphasalazine in the management of inflammatory bowel disease, this complication has been apparently rare. Clinicians should be wary of the onset of diarrhea in patients receiving sulphasalazine, whether for inflammatory bowel disease or other conditions.

scholarly journals Synchronous Occurrence of Collagenous and Pseudomembranous Colitis

2000 ◽  
Vol 14 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Z Vesoulis ◽  
G Lozanski ◽  
T Loiudice
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Pseudomembranous Colitis ◽  
Collagenous Colitis ◽  
Watery Diarrhea ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Unique Association ◽  
Idiopathic Inflammatory Bowel Disease

Synchronous collagenous and pseudomembranous colitis has not been previously reported. A 73-year-old woman presented with chronic watery diarrhea and abdominal cramping of six weeks’ duration. Biopsies of the colon revealed findings of collagenous colitis involving the endoscopically normal right colon, and superimposed collagenous and pseudomembranous colitis involving the rectosigmoid colon. Endoscopically, the left colon revealed discrete ulcerative plaques, andClostridium difficiletoxin A assay was positive. The patient partially responded to a three-week regimen of metronidazole, and symptoms resolved completely with subsequent steroid therapy. At follow-up endoscopy four months later, colon biopsies demonstrated persistence of subepithelial collagen but no pseudomembranes. The patient remained asymptomatic during this interval. Collagenous colitis has been reported in association with other inflammatory bowel diseases, including lymphocytic colitis, sprue and idiopathic inflammatory bowel disease. This unique association of collagenous colitis with an endotoxigenic inflammatory bowel disease is presented with a review of related disease features.

Clostridium Difficile Infection in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 19 (7) ◽  
pp. 929-935
Author(s):  
Abdulmajeed A. Albarrak ◽  
Bhupinder S. Romana ◽  
Suleyman Uraz ◽  
Mohamad H. Yousef ◽  
Alhareth A. Juboori ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Bowel Disease ◽  
Health Care Organizations ◽  
Fecal Microbiota ◽  
Fecal Microbiota Transplant ◽  
Expert Review ◽  
Inflammatory Bowel ◽  
High Index Of Suspicion

Background:The rising incidence of Clostridium difficile infection (CDI) in the general population has been recognized by health care organizations worldwide. The emergence of hypervirulent strains has made CDI more challenging to understand and treat. Inflammatory bowel disease (IBD) patients are at higher risk of infection, including CDI.Objective:A diagnostic approach for recurrent CDI has yet to be validated, particularly for IBD patients. Enzyme immunoassay (EIA) for toxins A and B, as well as glutamate dehydrogenase EIA, are both rapid testing options for the identification of CDI. Without a high index of suspicion, it is challenging to initially differentiate CDI from an IBD flare based on clinical evaluation alone.Methods:Here, we provide an up-to-date review on CDI in IBD patients. When caring for an IBD patient with suspected CDI, it is appropriate to empirically treat the presumed infection while awaiting further test results.Results:Treatment with vancomycin or fidaxomicin, but not oral metronidazole, has been advocated by an expert review from the clinical practice update committee of the American Gastroenterology Association. Recurrent CDI is more common in IBD patients compared to non-IBD patients (32% versus 24%), thus more aggressive treatment is recommended for IBD patients along with early consideration of fecal microbiota transplant.Conclusion:Although the use of infliximab during CDI has been debated, clinical experience exists supporting its use in an IBD flare, even with active CDI when needed.

Clostridium Difficile Infection and Biliary Obstruction

2021 ◽  
Vol 8 (1) ◽  
pp. 01-06
Author(s):  
Marilena Stoian
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Crohn Disease ◽  
Bowel Disease ◽  
Biliary Obstruction ◽  
Hepatobiliary Disease ◽  
Protein Loss ◽  
Protein Losing Enteropathy ◽  
Inflammatory Bowel

We present a case of a 38-year -old man was admitted to the hospital with biliary obstruction and Clostridium Difficile infection. He presented with moderate increases in the aminotransferase and bilirubin levels suggesting the diagnosis of an autoimmune hepatobiliary disease; intestinal protein loss needs to evaluate an associated inflammatory bowel disease. The clinical diagnosis of autoimmune hepatobiliary disease associated with inflammatory bowel disease is based on the patients symptoms and the presence of a protein-losing enteropathy which are more suggestive of Crohn disease, while moderate increases in the aminotransferase levels in proportion to the increase in the bilirubin level suggesting the diagnosis of primary sclerosing cholangitis. The pathological and positive diagnosis needs an endoscopic retrograde cholangiopancreatography and a biopsy of gastric and duodenum mucosae who showed severe inflammation findings that are diagnostic of Crohn disease.

scholarly journals Increased Rate of Venous Thromboembolism in Hospitalized Inflammatory Bowel Disease Patients with Clostridium Difficile Infection

2017 ◽  
Vol 23 (10) ◽  
pp. 1847-1852 ◽  
Author(s):  
Sanjay Bhandari ◽  
Mubeen Khan Mohammed Abdul ◽  
Binod Dhakal ◽  
Lisa Baumann Kreuziger ◽  
Kia Saeian ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Bowel Disease ◽  
Inflammatory Bowel
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