Mehershahi Shehriyar, Ghazanfar Haider, Ashraf Shoaib, Shaikh Danial H, Ihimoyan Ariyo
Department of Gastroenterology, Bronxcare Health System, Bronx, New York, USA.
Department of Medicine, Bronxcare Health System, Bronx, New York, USA.
Case Rep Gastroenterol. 2021 Mar 15;15(1):372-378. doi: 10.1159/000513165. eCollection 2021 Jan-Apr.
Colitis is a chronic gastrointestinal system disease characterized by inflammation of the inner lining of the colon. Infectious colitis is one of the most common causes of colitis and is associated with significant mortality and morbidity. One of the rare causes of colitis includes vancomycin-resistant (VRE). Lately, the prevalence of VRE has significantly increased in hospitals. We present a case of a 32-year-old American man who was initially admitted because of bilateral lower extremity weakness. The hospital course was complicated, with acute hypoxic respiratory failure secondary to pneumonia. The patient was intubated and was started on broad-spectrum antibiotics. Later on, the patient had severe diarrhea and was found to have clostridium difficile infection. Patient symptoms persisted despite completing the course of antibiotics. Colonoscopy was performed, and the patient was found to have a diffuse area of severely altered vascular, congested, erythematous, friable with contact bleeding, hemorrhagic, inflamed, nodular, and ulcerated mucosa in the sigmoid colon, in the descending colon, and the transverse colon. A biopsy was sent, and the patient was found to be growing VRE. Currently, there is no effective treatment available for VRE. Hospitals need to have an active surveillance program to identify these patients so that the infection does not spread to other patients.
结肠炎是一种慢性胃肠系统疾病,其特征为结肠内层炎症。感染性结肠炎是结肠炎最常见的病因之一,且与显著的死亡率和发病率相关。结肠炎的罕见病因之一包括耐万古霉素肠球菌(VRE)。最近,医院中VRE的患病率显著上升。我们报告一例32岁美国男性病例,该患者最初因双侧下肢无力入院。住院过程复杂,继发于肺炎的急性缺氧性呼吸衰竭。患者接受了气管插管,并开始使用广谱抗生素。后来,患者出现严重腹泻,被发现患有艰难梭菌感染。尽管完成了抗生素疗程,但患者症状仍持续。进行了结肠镜检查,发现患者在乙状结肠、降结肠和横结肠有弥漫性区域,血管严重改变、充血、红斑、质脆伴接触性出血、出血、发炎、结节状及溃疡的黏膜。送检了活检,发现患者感染了VRE。目前,对于VRE尚无有效的治疗方法。医院需要有一个积极的监测项目来识别这些患者,以便感染不会传播给其他患者。