Multidrug Resistance and Flaring up of Manifestation in Fistulizing Crohn's Disease after Surgery on a Perianal Lesion.

Autor: Ali AS; Pathology Department, Faculty of Medicine, Umm Al-Qurra University, Mecca, Saudi Arabia., Alhothali OS; Fifth year medical student, Umm Al-Qurra University, Mecca, Saudi Arabia., Hammoudah AA; Fifth year medical student, Umm Al-Qurra University, Mecca, Saudi Arabia., Kh Alsaede A; Fifth year medical student, Umm Al-Qurra University, Mecca, Saudi Arabia., Alraddadi AA; Fifth year medical student, Umm Al-Qurra University, Mecca, Saudi Arabia.
Jazyk: angličtina
Zdroj: Case reports in gastroenterology [Case Rep Gastroenterol] 2021 Jul 08; Vol. 15 (2), pp. 626-631. Date of Electronic Publication: 2021 Jul 08 (Print Publication: 2021).
DOI: 10.1159/000515611
Abstrakt: Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract with relapsing and remitting episodes. Abscesses and fistulas are the most common presentations of anorectal Crohn's disease. Antibiotics and surgical incision and drainage have been successful in treating perianal disease. We present here a 48-year-old woman with known case of Crohn's disease who presented with massive swelling in the perianal region with severe throbbing pain and high-grade fever, 38.2°C; the surgeon noted a large perianal abscess near the anal verge with redness, hotness, and tenderness. One and a half months from perianal abscess surgery, culture sensitivity was done due to delayed wound healing and passage of greenish discharge, and it revealed highly resistant bacteria Proteus mirabilis , Escherichia coli , and Staphylococci. In conclusion, clinicians should be aware that abscess and fistula have a fair chance to develop in Crohn's disease patients who are using immunomodulating and immunosuppressant therapy. In abscess and fistula cases, surgery should be determined as soon as possible, and close clinical monitoring should be performed. We recommend routine screening for enteric fistula and culture sensitivity of any discharge prior to the initiation of any antibiotic. Appropriate intervention should then be undertaken.
Competing Interests: The authors have no conflicts of interest to declare.
(Copyright © 2021 by S. Karger AG, Basel.)
Databáze: MEDLINE
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