Colonoscopy in the Diagnosis of Antibiotic-Associated Colitis

Abstract

Colonoscopic findings among 16 patients with histologically proved antibiotic-associated pseudomembranous colitis (PMC) were analyzed. The characteristic endoscopic changes of PMC with pseudomembranes were observed in only 5 (31%) out of 16 patients by sigmoidoscopy but in 11 (85%) out of 13 patients in whom colonoscopy was also performed. The findings suggest the importance of colonoscopy in the early diagnosis of PMC and indicate that the typical endoscopic changes of PMC are limited to the colon above the rectosigmoid area in most patients with antibiotic-associated colitis. It is emphasized that colonoscopy should be performed at least in clinically suspected PMC cases, in which the early diagnosis of PMC might be missed if sigmoidoscopy alone is performed.

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

“…Rectal sparing may be present in up to 60-70% of patients with AAC and PMC [21,65]. This is clinically important since proctoscopy alone may not detect these changes [10,17,21,65,68,[70][71][72]. Flexible sigmoidoscopy should be cautiously performed to confirm the diagnosis of PMC in all patients only exception is a toxic patient where high risk for perforation may exist as the disease progresses [52,[67][68][69][74][75][76][77].…”

“…Flexible sigmoidoscopy should be cautiously performed to confirm the diagnosis of PMC in all patients only exception is a toxic patient where high risk for perforation may exist as the disease progresses [52,[67][68][69][74][75][76][77]. Besides collecting tissue for culture assays or histology, decompression after assessment may be considor other inflammatory entities in patients with diarrhea, ered if abdominal distension is present [51,68,76,77]. fever, and abdominal pain [60].…”

“…These 2-3 mm in diameter plaques represent the classic pseudomembrane ( fig. 2) [22,26,29,[65][66][67][68]. They are composed of fibrin, epithelial debris, bacteria, mucus and leukocytes [29,51,[68][69][70].…”

Peritoneal Dialysis–Related Peritonitis Triggered by Clostridium difficile–Associated Colitis

“…The incidence of this complication ranges from 1.6% to 10% in the adult population (1-3); in pediatric patients, an incidence of up to 3% has been reported (4). The postulated mechanisms of its pathogenesis are pleural-peritoneal communication (2,5), congenital or acquired anatomic defects of the diaphragm causing a track between the peritoneal cavity and the pleural space (6-8), and defective lymphatic drainage resulting from a difference in pressure gradient between the peritoneal cavity and the pleural cavity (9).…”

Laboratory Investigation of Childhood Enteric Infections

“…Full colonoscopy increases detection of / pseudomembranes from 30% of antibiotic-associated colitis patients to 85% (122] but is not recommended in severely ill patients. Microscopic examination of stools is not helpful.…”