Kelly J, Oryshak A, Wenetsek M, Grabiec J, Handy S
Department of Pathology, Foothills Hospital, Calgary, Alberta, Canada.
Am J Surg Pathol. 1990 Jan;14(1):87-92. doi: 10.1097/00000478-199001000-00010.
We report the colonic pathology of two surgical excisions and two autopsies from patients acutely infected by E. coli O157:H7. The right colon was most severely affected. Extreme edema, fibrin deposition, and hemorrhage in the submucosa was the most distinctive finding. All cases showed patchy mucosal ulceration, mucosal hemorrhage, neutrophil infiltration, and microvascular thrombi. Pseudomembranous lesions similar to those described in pseudomembranous colitis caused by Clostridium difficile were a minor feature. Advanced lesions displayed regenerative mucosal changes and heavy plasmacytic infiltration of submucosa. The colonic pathology may be due to bacterial verocytotoxin rather than to bacterial attachment-effacement or invasion.
我们报告了两例因感染大肠杆菌O157:H7而接受手术切除及两例尸检患者的结肠病理学情况。右半结肠受影响最为严重。最显著的发现是黏膜下层出现极度水肿、纤维蛋白沉积和出血。所有病例均呈现散在性黏膜溃疡、黏膜出血、中性粒细胞浸润及微血管血栓形成。类似于艰难梭菌所致伪膜性结肠炎中所描述的伪膜性病变为次要特征。进展期病变表现为黏膜再生性改变及黏膜下层大量浆细胞浸润。结肠病理学改变可能是由细菌的志贺毒素引起，而非细菌的黏附-脱落或侵袭。
