1/201. clostridium difficile colitis associated with infant botulism: near-fatal case analogous to Hirschsprung's enterocolitis.We present the first five reported cases of clostridium difficile-associated diarrhea (CDAD) in children with infant botulism caused by clostridium botulinum. We compare two fulminant cases of colitis in children with colonic stasis, the first caused by infant botulism and the second caused by Hirschsprung's disease. In both children, colitis was accompanied by hypovolemia, hypotension, profuse ascites, pulmonary effusion, restrictive pulmonary disease, and femoral-caval thrombosis. Laboratory findings included pronounced leukocytosis, hypoalbuminemia, hyponatremia, coagulopathy, and, when examined in the child with infant botulism, detection of C. difficile toxin in ascites. CDAD recurred in both children, even though difficile cytotoxin was undetectable in stool after prolonged initial therapy. Four children who had both infant botulism and milder CDAD also are described. Colonic stasis, whether acquired, as in infant botulism, or congenital, as in Hirschsprung's disease, may contribute to the susceptibility to and the severity of CDAD.- - - - - - - - - - ranking = 1keywords = enterocolitis (Clic here for more details about this article) |
2/201. Necroqizing enterocolitis with pneumatosis intestinalis in systemic lupus erythematosus and polyarteritis.Pneumatosis intestinalis was encountered in association with fatal necrotizing enterocolitis in systemic lupus erythematosus (SLE) and polyarteritis nodosa. The radiologic identification of mottled, bubbly, and linear collections of intramural intestinal gas distinguish this ominous complication from benign pneumatosis cystoides intestinalis. In the setting of intestinal vasculitis due to SLE or polyarteritis nodosa, these characteristic radiologic features indicate necrotizing enterocolitis. Since corticosteroids may mask clinical progression of the intestinal lesion, radiologic evaluation is essential in the overall management of the patient with intestinal vasculitis.- - - - - - - - - - ranking = 1.5011279708207keywords = enterocolitis, necrotizing (Clic here for more details about this article) |
3/201. Extracolonic manifestations of clostridium difficile infections. Presentation of 2 cases and review of the literature.clostridium difficile is most commonly associated with colonic infection. It may, however, also cause disease in a variety of other organ systems. Small bowel involvement is often associated with previous surgical procedures on the small intestine and is associated with a significant mortality rate (4 of 7 patients). When associated with bacteremia, the infection is, as expected, frequently polymicrobial in association with usual colonic flora. The mortality rate among patients with C. difficile bacteremia is 2 of 10 reported patients. Visceral abscess formation involves mainly the spleen, with 1 reported case of pancreatic abscess formation. Frequently these abscesses are only recognized weeks to months after the onset of diarrhea or other colonic symptoms. C. difficile-related reactive arthritis is frequently polyarticular in nature and is not related to the patient's underlying HLA-B27 status. fever is not universally present. The most commonly involved joints are the knee and wrist (involved in 18 of 36 cases). Reactive arthritis begins an average of 11.3 days after the onset of diarrhea and is a prolonged illness, taking an average of 68 days to resolve. Other entities, such as cellulitis, necrotizing fasciitis, osteomyelitis, and prosthetic device infections, can also occur. Localized skin and bone infections frequently follow traumatic injury, implying the implantation of either environmental or the patient's own C. difficile spores with the subsequent development of clinical infection. It is noteworthy that except for cases involving the small intestine and reactive arthritis, most of the cases of extracolonic C. difficile disease do not appear to be strongly related to previous antibiotic exposure. The reason for this is unclear. We hope that clinicians will become more aware of these extracolonic manifestations of infection, so that they may be recognized and treated promptly and appropriately. Such early diagnosis may also serve to prevent extensive and perhaps unnecessary patient evaluations, thus improving resource utilization and shortening length of hospital stay.- - - - - - - - - - ranking = 0.00056398541033159keywords = necrotizing (Clic here for more details about this article) |
4/201. Hyperviscosity syndrome associated with necrotizing enterocolitis.Hyperviscosity, or decreased fluidity secondary to increased numbers of red blood cells, leads to tissue hypoperfusion. We report the case of an infant with hyperviscosity who died from necrotizing enterocolitis (NEC), and describe the presumptive association between NCE and hyperviscosity.- - - - - - - - - - ranking = 1.2528199270517keywords = enterocolitis, necrotizing (Clic here for more details about this article) |
5/201. Neonatal necrotizing enterocolitis. Occurrence secondary to thrombosis of abdominal aorta following umbilical arterial catheterization.A patient had neonatal necrotizing enterocolitis (NNE), secondary to aortic thrombosis following umbilical arterial catheterization. The thrombus occluded the ostium of the inferior mesenteric artery. A review of cases reported in the literature with complications following umbilical arterial catheterization revealed four instances of NNE or NNE-like lesions due to thrombosis of the abdominal aorta or one of its major branches. thrombosis of the aorta, with occlusion of one or more of its major abdominal branches following umbilical arterial catheterization, should be considered as a potential etiologic factor in certain cases of NNE.- - - - - - - - - - ranking = 1.2528199270517keywords = enterocolitis, necrotizing (Clic here for more details about this article) |
6/201. Ulcerative colitis complicating pseudomembranous colitis of the right colon.A 65-year-old man in the remission stage of ulcerative colitis developed severe bloody diarrhea and high fever. He was treated with imipenem/cilastatin and clindamycin for infectious enterocolitis at a local hospital, but there was no improvement in his condition. Steroid pulse therapy was also ineffective. colonoscopy revealed pseudomembranous colitis extending from the ascending colon to the cecum, and clostridium difficile toxin was positive in the feces. The administration of vancomycin in addition to oral steroids resulted in rapid improvement of the condition. Total colonoscopy is recommended for precise diagnosis when patients with ulcerative colitis develop intractable diarrhea during or after antibiotic therapy.- - - - - - - - - - ranking = 0.25keywords = enterocolitis (Clic here for more details about this article) |
7/201. life-threatening enterocolitis after gold salt therapy.Two patients developed life-threatening enterocolitis after receiving gold salt therapy. This disorder is attended by a mortality rate of 50% but the intestinal lesion appears to be reversible. The mechanism of the drug toxicity is not known. The course may be fulminant and recovery may occur only after many weeks. Total bowel rest, nasogastric suction, total parenteral nutrition with supplemental colloid and careful monitoring of fluid and electrolyte balance may improve survival.- - - - - - - - - - ranking = 1.25keywords = enterocolitis (Clic here for more details about this article) |
8/201. Necrotizing enterocolitis with recurrent hepatic portal venous gas.Two separate episodes of pneumatosis intestinalis and hepatic portal venous gas were observed in a premature infant with necrotizing enterocolitis. Although HPVG has previously been considered an ominous roentgenographic sign, the infant survived without surgical intervention. As in several cases reported by others, clinical and roentgenographic signs of NEC reappeared when enteric feedings were restarted prior to 10 days of medical therapy.- - - - - - - - - - ranking = 1.2505639854103keywords = enterocolitis, necrotizing (Clic here for more details about this article) |
9/201. Drug-induced pseudomembranous enterocolitis: a new etiologic agent.Pseudomembranous enterocolitis is an iatrogenic illness resulting from the oral or intramuscular use of broad-spectrum antibiotics. It is characterized by diarrhea, mucosal inflammation, and pseudomembrane formation in the gastrointestinal tract. The diagnosis is established by an index of suspicion in individuals who have been on antibiotic therapy, proctosigmoidoscopic examination, stool smears, cultures, and sensitivity. Treatment should be directed to eliminating the etiologic factor and replacing the physiologic abnormality.- - - - - - - - - - ranking = 1.25keywords = enterocolitis (Clic here for more details about this article) |
10/201. Disseminated intravascular thrombosis as the cause of ischaemic enterocolitis.Disseminated intravascular thrombosis was diagnosed in a woman aged 63 years. At autopsy the typical appearances of ischaemic enterocolitis were found, together with thrombi in other organs. This case illustrates the previously postulated connection between intravascular thrombosis and ischaemic enterocolitis.- - - - - - - - - - ranking = 1.5keywords = enterocolitis (Clic here for more details about this article) |
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