Nash S V, Bourgeault R, Sands M
Department of Pathology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
J Clin Gastroenterol. 1997 Sep;25(2):476-9. doi: 10.1097/00004836-199709000-00018.
In this retrospective review of colonic tissue from 21 patients with a positive stool assay for Clostridium difficile toxin, four groups of patients were identified by pathologic examination. Classic pseudomembranous colitis was identified in 38% of patients in colon biopsies, resections, and at postmortem examination. One third of patients had acute colitis without specific features on colon biopsies at the time of a positive toxin assay. Effects of C. difficile toxin in patients with idiopathic inflammatory bowel disease (10%) could not be pathologically separated from activity of the underlying disease. In 19% of patients, no acute or chronic colitis or pseudomembranous colitis was noted. This report reminds gastroenterologists that C. difficile infection is associated with a range of pathologic changes similar to the well known clinical spectrum of disease.
在这项对21例粪便艰难梭菌毒素检测呈阳性患者的结肠组织进行的回顾性研究中，通过病理检查确定了四组患者。在结肠活检、切除术及尸检中，38%的患者被诊断为典型的伪膜性结肠炎。三分之一的患者在毒素检测呈阳性时，结肠活检显示为无特异性特征的急性结肠炎。10%患有特发性炎症性肠病的患者中，艰难梭菌毒素的影响在病理上无法与潜在疾病的活动相区分。19%的患者未发现急性或慢性结肠炎或伪膜性结肠炎。本报告提醒胃肠病学家，艰难梭菌感染与一系列病理变化相关，类似于众所周知的疾病临床谱。
