Tang Ying M, Stone Christian D
Section of Gastroenterology and Hepatology, Division of Gastroenterology and Hepatology, University of Nevada School of Medicine, 1701 W. Charleston Blvd, Suite 230, Las Vegas, NV, 89102, USA.
Comprehensive Digestive Institute of Nevada, 8530 W. Sunset Rd, Suite 230, Las Vegas, NV, 89113, USA.
Clin J Gastroenterol. 2017 Apr;10(2):112-123. doi: 10.1007/s12328-017-0719-2. Epub 2017 Feb 16.
The problem of Clostridium difficile infection (CDI) has reached epidemic proportions, particularly in industrialized nations. The pathophysiology, disease course and the potential complications are well appreciated in the general hospitalized patient. However, when CDI occurs in the setting of inflammatory bowel disease (IBD), a number of distinct differences in the diagnosis and clinical management of the infection in this population should be appreciated by gastroenterologists, hospitalists and other care providers. This review highlights the unique aspects of CDI when it occurs in IBD patients with an emphasis on the challenge of distinguishing persistent infection from exacerbation of underlying chronic colitis. An understanding of how CDI may differ in presentation and how management should be altered can prevent serious and life-threatening complications.
艰难梭菌感染（CDI）问题已达到流行程度，尤其是在工业化国家。一般住院患者对其病理生理学、病程及潜在并发症已有充分认识。然而，当CDI发生于炎症性肠病（IBD）背景下时，胃肠病学家、住院医师及其他医疗服务提供者应认识到该人群感染的诊断和临床管理存在一些明显差异。本综述重点介绍了IBD患者发生CDI时的独特方面，强调了区分持续性感染与潜在慢性结肠炎加重的挑战。了解CDI在表现上的差异以及应如何改变管理方式可预防严重及危及生命的并发症。
