Wiggelinkhuizen Miranda, Gerrits Manfred A N
Tergooiziekenhuizen, afd. Chirurgie, Blaricum, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155(49):A2414.
Clostridium difficile infection usually manifests as pseudomembranous colitis. Infection of the small intestine is rare. C. difficile enteritis has a high mortality rate due to secondary enteric necrosis and perforation.
We describe an 87-year-old woman with abdominal pain, who died from necrotizing enteritis due to a C. difficile infection. This is the first described case of small bowel involvement in the absence of known risk factors for C. difficile enteritis, i.e. bowel surgery and recent use of antibiotics. The described patient was using immunosuppressants, which in this case could have been a risk factor for small bowel colonization with C. difficile.
In clinical practice it is important to be prepared for C. difficile infection, as early treatment of this infection will strongly improve the prognosis. Identification of patients at an increased risk of C. difficile infection is of great value in this respect.
艰难梭菌感染通常表现为伪膜性结肠炎。小肠感染较为罕见。艰难梭菌肠炎因继发性肠坏死和穿孔而死亡率较高。
我们报告一名87岁腹痛女性,死于艰难梭菌感染所致的坏死性肠炎。这是首例在无艰难梭菌肠炎已知危险因素(即肠道手术和近期使用抗生素)情况下出现小肠受累的病例。所描述的患者正在使用免疫抑制剂,在这种情况下这可能是小肠被艰难梭菌定植的一个危险因素。
在临床实践中,对艰难梭菌感染做好准备很重要,因为尽早治疗这种感染将显著改善预后。在这方面,识别艰难梭菌感染风险增加的患者具有重要价值。