Jakobsen Lars, Tvede Michael
Herning Sygehus, Medicinsk Afdeling, og H:S Rigshospitalet.
Ugeskr Laeger. 2006 Apr 24;168(17):1634-5.
We describe a case of pseudomembraneous colitis (PMC) caused by a toxin A- B+ strain of Clostridium difficile (CD). In Denmark only a few laboratories investigate for toxin production, and if they do, the toxin A enzyme immunoassay (EIA) is the test generally used when testing for CD. This toxin A negative but toxin B positive strain thus remains undetectable. If CD-associated diarrhea is clinically suspected and tests for toxin A are negative, infection with a toxin A- B+ strain should be considered. Further diagnostic tests such as cellular cytotoxicity assays or toxin A/B EIA should be performed. The standard treatment of PMC in severely ill patients should be vancomycin, administered orally.
我们描述了一例由艰难梭菌（CD）毒素A阴性但毒素B阳性菌株引起的伪膜性结肠炎（PMC）病例。在丹麦，只有少数实验室检测毒素产生情况，而且如果进行检测，毒素A酶免疫测定（EIA）是检测CD时通常使用的检测方法。因此，这种毒素A阴性但毒素B阳性的菌株仍然无法检测到。如果临床上怀疑有与CD相关的腹泻且毒素A检测为阴性，则应考虑感染了毒素A阴性但毒素B阳性的菌株。应进行进一步的诊断检测，如细胞毒性测定或毒素A/B EIA。重症患者PMC的标准治疗应为口服万古霉素。
