Melinte Violeta, Radu Adelina M, Văcăroiu Cristina M, Cismaru Miriana I, Oprescu Macovei Anca M, Mihăilă Daniela E, Gheorghiță Valeriu
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Agrippa Ionescu Clinical Emergency Hospital, 011356 Bucharest, Romania.
Diagnostics (Basel). 2024 Apr 11;14(8):801. doi: 10.3390/diagnostics14080801.
Shiga-like toxin-producing Escherichia coli (STEC) is a well-known cause of foodborne acute diarrheic diseases, especially in children and the elderly. The potentially fatal complications associated with toxin production range from bloody diarrhea and ischemic colitis to kidney failure, hemolytic-uremic syndrome (HUS), and colon perforation. Here, we describe a case and literature review of STEC-induced colitis, highlighting the clinical features and the necessary tools for the best diagnostic approach and management. Facing challenging differential diagnosis, ranging from ischemic colitis and inflammatory bowel disease to infectious processes due to a pathogenic or opportunistic agent, we conducted a step-by-step exploration. Following bacteriological investigation, imagistic screening, and colonoscopy, we ruled out some of the initial suppositions and reached a final diagnosis, while also considering the pathological results. Although antibiotics are not indicated in this pathology, our patient did receive antibiotics, given the risk of translocation and colon perforation, without any associated complications such as HUS or peritonitis. Detailed and rigorous investigations conducted by a multi-specialty team are required for prompt medical support. Coping with the symptoms and refraining from further complications are the mainstem aims of treatment.
产志贺毒素大肠杆菌(STEC)是食源性急性腹泻疾病的一个众所周知的病因,尤其是在儿童和老年人中。与毒素产生相关的潜在致命并发症范围从血性腹泻、缺血性结肠炎到肾衰竭、溶血尿毒综合征(HUS)和结肠穿孔。在此,我们描述一例STEC诱发结肠炎的病例并进行文献综述,重点介绍临床特征以及最佳诊断方法和管理所需的工具。面对具有挑战性的鉴别诊断,范围从缺血性结肠炎、炎症性肠病到由致病或机会性病原体引起的感染性疾病,我们进行了逐步探究。经过细菌学调查、影像学筛查和结肠镜检查,我们排除了一些最初的推测并得出最终诊断,同时也考虑了病理结果。尽管在这种病理情况下不建议使用抗生素,但鉴于有细菌易位和结肠穿孔的风险,我们的患者确实接受了抗生素治疗,且未出现任何诸如HUS或腹膜炎等相关并发症。多专业团队进行详细而严谨的调查对于及时的医疗支持是必要的。应对症状并避免进一步的并发症是治疗的主要目标。