<i>Clostridium difficile</i>enteritis: diffuse small bowel radiological changes in a patient with abdominal sepsis

Siddiqui, Juveria; Campion, Thomas R.; Wei, Rui; Kuzmich, Siarhei

doi:10.1136/bcr-2017-222209

Cited by 7 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Imaging provides clues in severe colonic inflammation: bowel wall thickening, thumbprinting, accordion sign, pericolonic stranding and ascites [ 108 , 109 , 110 ]. Similar findings, consisting of small bowel dilatation, wall thickening, and ascites, have been described in CD enteritis [ 111 , 112 ]. Abdominal ultrasound allows the assessment of disease extent and severity, and specific features for both CDI and IBD can be detected: thickening of the bowel wall, colonic dehaustration, free fluid between bowel loops, colonic dilatation, or free air in complicated cases.…”

Section: Diagnosis Of CDI In Ibdsupporting

confidence: 80%

The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases

et al. 2022

View full text Add to dashboard Cite

Clostridioides difficile (C. difficile) represents a major health burden with substantial economic and clinical impact. Patients with inflammatory bowel diseases (IBD) were identified as a risk category for Clostridioides difficile infection (CDI). In addition to traditional risk factors for C. difficile acquisition, IBD-specific risk factors such as immunosuppression, severity and extension of the inflammatory disease were identified. C. difficile virulence factors, represented by both toxins A and B, induce the damage of the intestinal mucosa and vascular changes, and promote the inflammatory host response. Given the potential life-threatening complications, early diagnostic and therapeutic interventions are required. The screening for CDI is recommended in IBD exacerbations, and the diagnostic algorithm consists of clinical evaluation, enzyme immunoassays (EIAs) or nucleic acid amplification tests (NAATs). An increased length of hospitalization, increased colectomy rate and mortality are the consequences of concurrent CDI in IBD patients. Selection of CD strains of higher virulence, antibiotic resistance, and the increasing rate of recurrent infections make the management of CDI in IBD more challenging. An individualized therapeutic approach is recommended to control CDI as well as IBD flare. Novel therapeutic strategies have been developed in recent years in order to manage severe, refractory or recurrent CDI. In this article, we aim to review the current evidence in the field of CDI in patients with underlying IBD, pointing to pathogenic mechanisms, risk factors for infection, diagnostic steps, clinical impact and outcomes, and specific management.

show abstract

Section: Diagnosis Of CDI In Ibdsupporting

confidence: 80%

The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The repeat CT scan revealed small bowel dilation, thickening, and moderate ascites. Siddiqui et al describes a case report of C. difficile enteritis with similar abdominal CT scan findings [11]. Thus, this suggests that the radiologic findings of C. difficile enteritis may mimic those of colitis.…”

Section: Discussionmentioning

confidence: 96%

Clostridium difficileEnteritis after Total Abdominal Colectomy for Ulcerative Colitis

Nasser

Munie

Shakaroun

et al. 2019

Case Reports in Critical Care

View full text Add to dashboard Cite

Introduction. Isolated Clostridium difficile small bowel enteritis is a rare condition with significant morbidity and mortality. Presentation of Case. An 83-year-old female with refractory ulcerative colitis underwent a total proctocolectomy and end ileostomy. Her postoperative course was complicated with return to the operating room for repair of an incarcerated port site hernia. Subsequently, she developed septic shock and multiorgan failure requiring intubation and mechanical ventilation, renal replacement therapy, and high dose vasopressors. Diagnostic workup revealed diffuse small bowel wall thickening on computed tomography scan as well as positive nucleic acid amplification test for C. difficile toxin B gene. Despite treatment with antibiotics and maximum attempts at resuscitation, the patient expired. Discussion. C. difficile infection most commonly affects the colon but rarely can involve the small bowel. The pathogenesis of C. difficile enteritis is unclear but is believed to mirror that of colitis. Surgical patients are susceptible for C. difficile infection, as they tend to be relatively immunosuppressed in the postoperative period. Radiologic findings of enteritis may mimic those of colitis and this includes small bowel dilation and thickening. Treatment for this condition has not been well established but it is approached similar to colitis. Conclusion. Despite an increase in the number of case reports of C. difficile enteritis, it continues to be a rare but potentially fatal infection. Clinicians should maintain a high index of suspicion especially in patients with inflammatory bowel disease who undergo colon resections.

show abstract

“…Veterinary studies were excluded, as were basic science studies and articles focusing on pediatric patients (age <18 years). Per our selection strategy, 77 reported cases were identified in 49 publications and our results are presented in Table 1 [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Clostridioides Difficile Enteritis: Case Report and Literature Review

et al. 2022

View full text Add to dashboard Cite

Background: Clostridioides Difficile is a well-known pathogen causing diarrhea of various degrees of severity through associated infectious colitis. However, there have been reports of infectious enteritis mainly in patients with ileostomy, causing dehydration through high-output volume; Case presentation: We report the case of a 46-year-old male patient, malnourished, who presented with high-output ileostomy following a recent hospitalization where he had suffered an ileo-colic resection with ileal and transverse colon double ostomy, for stricturing Crohn’s disease. Clostridioides Difficile toxin A was identified in the ileal output confirming the diagnosis of acute enteritis. Treatment with oral Vancomycin was initiated with rapid reduction of the ileostomy output volume; Conclusion: We report a case of Clostridioides Difficile enteral infection as a cause for high-output ileostomy, successfully treated with oral Vancomycin. We also review the existing literature data regarding this specific localized infection.

show abstract

Clostridium difficileenteritis: diffuse small bowel radiological changes in a patient with abdominal sepsis

Cited by 7 publications

References 10 publications

The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases

The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases

Clostridium difficileEnteritis after Total Abdominal Colectomy for Ulcerative Colitis

Clostridioides Difficile Enteritis: Case Report and Literature Review

Contact Info

Product

Resources

About