Pseudomembranous Colitis  

Oleh:

Chen, Naiming ; Shih, Shin-Lin

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 05 (Feb. 2011), page e8.
Topik: Crampy Abdominal Pain; Nausea; Vomiting; Watery Diarrhea; Leukocytosis
Fulltext: Pseudomembranous Colitis.pdf (124.68KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A 40-year-old woman presented to the hospital with crampy abdominal pain, nausea, vomiting, watery diarrhea, and leukocytosis (12,900 white cells per microliter). She was admitted with a presumptive diagnosis of infectious colitis and was treated with a 14-day course of ciprofloxacin, with a moderate response. Nine days after discharge, the patient returned to the emergency department with abdominal pain, vomiting, diarrhea, and hypotension. A contrast-enhanced computed tomographic scan of the abdomen showed marked bowel-wall thickening (Panel A, arrows) throughout the sigmoid colon and descending colon. Colonoscopy (Panel B) revealed multiple discrete, yellowish, polypoid lesions and a friable, hyperemic mucosa. Histopathological examination of the biopsy specimens revealed a neutrophilic infiltrate in the lamina propria and mucopurulent exudates erupting through the denuded surface epithelium, findings that confirmed a diagnosis of pseudomembranous colitis (Panel C, hematoxylin and eosin). Results of a test for Clostridium difficile toxin, performed 6 days after the second admission, were negative. The patient began treatment with antimicrobial agents and was discharged 117 days later, after complete resolution of the colitis.

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