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Non-clostridium difficile induced pseudomembranous colitis

Journal

WORLD JOURNAL OF CLINICAL CASES
Volume 11, Issue 5, Pages 979-988

Publisher

BAISHIDENG PUBLISHING GROUP INC
DOI: 10.12998/wjcc.v11.i5.979

Keywords

Infections; Pseudomembranous colitis; Gastroenteritis; Gastrointestinal diseases; Non-Clostridium difficile; Enterocolitis; Digestive system diseases

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Pseudomembranous colitis is a severe inflammation of the colon caused by various factors, with Clostridium difficile being the most common cause. Symptoms include abdominal pain, diarrhea, fever, and dehydration. Other than C. difficile, other pathogens, medications, and diseases should be considered as differential diagnoses. Complications can be serious, and early diagnosis and treatment are crucial.
Pseudomembranous colitis is severe inflammation of the inner lining of the colon due to anoxia, ischemia, endothelial damage, and toxin production. The majority of cases of pseudomembranous colitis are due to Clostridium difficile. However, other causative pathogens and agents have been responsible for causing a similar pattern of injury to the bowel with the endoscopic appearance of yellow-white plaques and membranes on the mucosal surface of the colon. Common presenting symptoms and signs include crampy abdominal pain, nausea, watery diarrhea that can progress to bloody diarrhea, fever, leukocytosis, and dehydration. Negative testing for Clostridium difficile or failure to improve on treatment should prompt evaluation for other causes of pseudomembranous colitis. Bacterial infections other than Clostridium difficile, Viruses such as cytomegalovirus, parasitic infections, medications, drugs, chemicals, inflammatory diseases, and ischemia are other differential diagnoses to look out for in pseudomembranous colitis. Complications of pseudomembranous colitis include toxic megacolon, hypotension, colonic perforation with peritonitis, and septic shock with organ failure. Early diagnosis and treatment to prevent progression are important. The central perspective of this paper is to provide a concise review of the various etiologies for pseudomembranous colitis and management per prior literature.

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