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Role of endopscopy in diagnostic of clostridium colitis

Publication at Second Faculty of Medicine |
2008

Abstract

Colitis caused by Clostridum difficile is a possible complication of antimicrobial therapy. Clostridum difficile was described in literature in 1935, but its importance is connected with the widespread of newer broad-spectrum antibiotics.

Changes of intestine microflora and subsequent production of toxins A and B by Clostridium difficile play the main role in ethiopathogenesis of the disease. The diagnosis is based on the detection of toxins A and B, eventually on cultivation of Clostridium difficile and the proof of toxigenity of particular tribe.

The role of endoscopy in diagnostic of this disease has been discussed. In our work we proved in 29 % of patient's pseudomembranous colitis, which is nearly always caused by Clostridium difficile.

In 27 % of patients we have diagnosed mild colitis, in 20 % of patients we diagnosed severe colitis without pseudomembranes. In 22 % of patients there was a coincidence of ulcerative colitis and colitis caused by Clostridum difficile.

Fulminant colitis has been diagnosed in one patient. In our group of 49 patients with the diagnoses of Clostridium difficile related colitis, endoscopy was a good diagnostic method - that was certainly carefully provided sigmoideoscopy without bowel preparation, when the material for toxin proof and cultivation was taken.