Rare Clinical Association between Clostridioides difficile Infection and Ischemic Colitis: Case Report and Literature Review.

Autor: Ionescu EM; Department of Gastroenterology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania., Curte AM; Department of Pathology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania., Olteanu AO; Department of Gastroenterology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania., Preda CM; Department of Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Gastroenterology, Fundeni Clinical Institute, 022328 Bucharest, Romania., Tieranu I; Department of Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania., Klimko A; Department of Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania., Tieranu CG; Department of Gastroenterology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.; Department of Gastroenterology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Jazyk: angličtina
Zdroj: Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2021 Jul 11; Vol. 57 (7). Date of Electronic Publication: 2021 Jul 11.
DOI: 10.3390/medicina57070705
Abstrakt: Background and Objectives: Gut microbiota plays an important role in the wellbeing of the host through different interactions between microflora constituents. In certain instances, Clostridioides difficile may pullulate, causing infection with associated colitis that may vary in terms of severity from mild disease to severe colitis, with increased associated mortality due to its complications. However, there are few literature data regarding the association between Clostridioides difficile and ischemic colitis. Case report: We report the case of a 30-year-old male patient, overweight, with impending dehydration, who presented with hematochezia and colicky abdominal pain, with positive fecal tests for the detection of Clostridioides difficile infection and endoscopic appearance suggesting ischemic colitis in the sigmoid and left colon, confirmed by computed tomography and histology. The patient was treated with oral Vancomycin, with resolution of symptoms, and was reevaluated through colonoscopy eight weeks after discharge, with endoscopic mucosal normalization and histological scarring process on biopsy samples. Conclusion: We report one of the few cases in the literature of ischemic colitis associated with Clostridioides difficile infection, with resolution of clinical, endoscopic, and histologic changes after specific treatment with oral Vancomycin suggesting a possible association between the two diseases. We also review the existing literature data regarding this comorbid association.
Databáze: MEDLINE