Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, New York.
Mod Pathol. 2023 Jul;36(7):100210. doi: 10.1016/j.modpat.2023.100210. Epub 2023 May 11.
Distinguishing inflammatory bowel disease (IBD) from its mimics remains a diagnostic challenge for surgical pathologists. Several gastrointestinal infections produce inflammatory patterns that overlap with typical findings of IBD. Although stool culture, PCR, and other clinical assays may identify infectious enterocolitides, these tests may not be performed or the results may be unavailable at the time of histologic evaluation. Furthermore, some clinical tests, including stool PCR, may reflect past exposure rather than an ongoing infection. It is important for surgical pathologists to be knowledgeable about infections that simulate IBD to generate an accurate differential diagnosis, perform appropriate ancillary studies, and prompt clinical follow-up. This review covers bacterial, fungal, and protozoal infections in the differential diagnosis of IBD.
鉴别炎症性肠病(IBD)与其类似疾病仍然是外科病理学家面临的一项诊断挑战。一些胃肠道感染会产生与 IBD 典型表现重叠的炎症模式。尽管粪便培养、PCR 及其他临床检测可识别出传染性肠炎,但这些检测可能无法进行,或者在组织学评估时无法获得结果。此外,一些临床检测,包括粪便 PCR,可能反映的是既往暴露而非正在发生的感染。外科病理学家需要了解模拟 IBD 的感染,以便做出准确的鉴别诊断、进行适当的辅助研究,并及时进行临床随访。本文综述了在 IBD 鉴别诊断中涉及的细菌、真菌和原虫感染。
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