Benetti G L, Montanelli F, Nuti R
U.O. Pediatria, U.S.L. 15, Volterra (PI), Italia.
Pediatr Med Chir. 1994 Jan-Feb;16(1):87-8.
"Pseudomembranous colitis" is a disease which has gained importance in the last decades. It is caused by intestinal colonization by "Clostridium Difficilis" which in normal situations, especially in the evolutive age, is a component of the normal saprophytic flora. Antibiotic therapy, or reduction of the immunological defenses by surgical procedures, infections, weakening diseases or malnutrition states may produce an alteration of the intestinal flora with a prevalence of Clostridium Difficilis which causes, with its intestinal toxin, organic and functional damages. The diagnosis is based on clinical symptoms and on endoscopic picture. The isolation of Clostridium Difficilis and its toxin in the patient's faeces is possible only in well-trained laboratories. The disease subsides with antibiotic interruption and with Vancomycin oral therapy. The Authors describe a paradigmatic case characterized by the simultaneous presence of antibiotic therapy, surgical procedure, characteristic endoscopic picture and by the prompt clinical and endoscopic recovery with Vancomycin.
“伪膜性结肠炎”是一种在过去几十年中受到重视的疾病。它由“艰难梭菌”在肠道定植引起,在正常情况下,尤其是在成年期,艰难梭菌是正常腐生菌群的一个组成部分。抗生素治疗,或通过外科手术、感染、虚弱性疾病或营养不良状态导致免疫防御功能降低,可能会引起肠道菌群改变,使艰难梭菌占优势,其肠道毒素会造成器质性和功能性损害。诊断基于临床症状和内镜表现。仅在训练有素的实验室中才有可能从患者粪便中分离出艰难梭菌及其毒素。停用抗生素并采用万古霉素口服治疗后,疾病会消退。作者描述了一个典型病例,其特点是同时存在抗生素治疗、外科手术、典型的内镜表现,以及使用万古霉素后临床和内镜迅速恢复。