colitis caused by escherichia coli 01587:h7: a study of six cases
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ID: 237087
1990
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Abstract
The clinical and pathologic features of six patients with proven
verotoxin-producing Escherichia coli colitis are described. Clinical data, 25 biopsy
specimens and two autopsies from these patients are reviewed. All presented with
crampy abdominal pain and bloody diarrhea. Colonoscopic findings included
edema, erythema, pseudomembranes and hemorrhage. On biopsy, two patients
had ischemic colitis, one had pseudomembranous colitis and three had a combination of concurrent ischemic and pseudomembranous colitis. Four cases
showed fibrin-platelet thrombi in mucosal capillaries and submucosal arterioles.
The classical pattern of infectious colitis was not seen in these cases. Other
nonspecific changes included patchy mucosal edema, congestion, focally
prominent interstitial hemorrhage and mild, patchy increase of the lymphoplasmocytic
component of the lamina. Ischemic necrosis was present in 10 of 25
biopsies (40%), pseudomembranes in seven of 25 biopsies (28%), and four of 25
biopsies (16%) showed both. Colon from one autopsy revealed edema, pseudo membranes
and intramural infarction . Concurrent thrombotic thrombocytopenic
purpura was clinically documented in three of six patients. It is
concluded that, in the context of hemorrhagic colitis, the following observations
are indicative of E coli 0157:H7: the combination of pseudomcmbranous and
ischemic colitis; ischemic colitis in a young patient; or pseudomembranous colitis
with Clostridium difficile-negative culture and toxin. Multiple biopsies are required
to demonstrate the full-blown features. E coli 0157:H7 colitis should be
added to the differential diagnosis of submucosal edema.
| Reference Key |
eidus1990canadiancolitis
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|---|---|
| Authors | ;LB Eidus;M Guindi;J Drouin;S Gregoire;JR Barr |
| Journal | indian journal of pharmacology |
| Year | 1990 |
| DOI |
10.1155/1990/125627
|
| URL | |
| Keywords |
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