Rutgeerts P, Geboes K, Ponette E, Coremans G, Vantrappen G
Endoscopy. 1982 Nov;14(6):212-9. doi: 10.1055/s-2007-1021624.
In a 4-year period 45 patients were admitted to our gastroenterological u nit with acute infective colitis. The endemic pathogens responsible for the colitis were Yersinia enterocolitica (46%), Campylobacter fetus jejuni (20%), common Salmonellae (13%), less virulent strains of Shigella (9%), Entamoeba hystolytica (7%) and Cytomegalovirus (4%). These microorganisms caused very severe disease in 18% of the patients, who were mostly predisposed. While Salmonella- and amoebic colitis always mimicked ulcerative colitis by the presence of diffuse lesions, the other pathogens caused focal colitis, thus necessitating differential diagnosis vis a vis Crohn's colitis. Two patients (4%) died of complications, while 93% of the patients were cured by proper antimicrobial therapy. In the same period 12 patients were admitted with an acute attack of inflammatory bowel disease due to an intercurrent infection with the same pathogens. In most of these patients clinical remission of IBD was achieved by treating the intercurrent infection. These data indicate that in the presence of an acute attack of colitis an infective etiologic agent must always be sought, and that an attack of chronic idiopathic inflammatory bowel disease may be caused by an intercurrent infection.
在4年期间，45例急性感染性结肠炎患者入住我们的胃肠病科。引起结肠炎的地方性病原体为小肠结肠炎耶尔森菌（46%）、空肠弯曲菌胎儿亚种（20%）、常见沙门菌（13%）、毒力较弱的志贺菌菌株（9%）、溶组织内阿米巴（7%）和巨细胞病毒（4%）。这些微生物在18%的患者中引起了非常严重的疾病，这些患者大多有易患因素。虽然沙门菌性结肠炎和阿米巴性结肠炎总是因弥漫性病变的存在而类似溃疡性结肠炎，但其他病原体引起局灶性结肠炎，因此需要与克罗恩结肠炎进行鉴别诊断。2例患者（4%）死于并发症，而93%的患者通过适当的抗菌治疗治愈。同期有12例患者因并发相同病原体感染而出现炎症性肠病急性发作。在这些患者中的大多数，通过治疗并发感染实现了炎症性肠病的临床缓解。这些数据表明，在结肠炎急性发作时，必须始终寻找感染性病因，并且慢性特发性炎症性肠病的发作可能由并发感染引起。
