Infliximab Rescue in Acute Severe Ulcerative Colitis Complicated by Clostridium Difficile Infection: A Case Series.
| Autor: | Markovic S; Gastroenterology and Hepatology, University Hospital Medical Center 'Zvezdara', Belgrade, SRB., Jankovic M; Gastroenterology and Hepatology, University Hospital Medical Center 'Zvezdara', Belgrade, SRB., Kalaba A; Gastroenterology and Hepatology, University Hospital Medical Center 'Zvezdara', Belgrade, SRB., Zogovic B; Department of General Surgery, Royal Prince Alfred Hospital, New South Wales, AUS., Sreckovic SS; Gastroenterology and Hepatology, University Hospital Medical Center 'Zvezdara', Belgrade, SRB. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2021 Oct 25; Vol. 13 (10), pp. e19019. Date of Electronic Publication: 2021 Oct 25 (Print Publication: 2021). |
| DOI: | 10.7759/cureus.19019 |
| Abstrakt: | Relapses in inflammatory bowel disease (IBD) complicated by Clostridium difficile infection (CDI) are associated with significant morbidity and mortality. CDI can exacerbate the course of IBD and may result in prolonged hospitalizations, admissions to intensive care, surgical interventions, or even death. Early detection and aggressive treatment with systemic corticosteroids or biologics such as infliximab are often needed in severe presentations. Five cases of relapsed ulcerative colitis complicated by fulminant CDI were retrospectively reviewed. Biological therapy with infliximab was initiated upon multidisciplinary team assessment as the cases were resistant to standard IBD therapy. All five patients improved clinically and avoided early surgical intervention. Some required prolonged therapy with infliximab to achieve remission. Early recognition of CDI and aggressive therapy with biologics may be required to avoid complications in the IBD patients experiencing a relapse. Infliximab therapy should be considered early on, especially where the disease is resistant to standard therapy. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2021, Markovic et al.) |
| Databáze: | MEDLINE |
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