• Title/Summary/Keyword: Pseudomembranous

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A Case of Clostridium difficile Pseudomembranous Colitis (Clostridium difficile 감염에 의한 위막성 대장염 1례)

  • Seo, Jung-Ho;Lee, Jong-Won;Lee, Chang-Han;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.98-104
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    • 2000
  • Pseudomembranous colitis, thought to be uncommon in children, is a bacterial, toxin-mediated inflammatory process resulting in acute or chronic diarrhea and is characterized by colonic pseudomembranes. It is mediated by toxins produced by Clostridium difficile and is increasingly recognized in pediatric population. Diagnosis is based on positive culture of C. difficile in selective media and positive test of C. difficile toxin. Oral metronidazole or vancomycin are the main treatment options but avoidance of further antibiotics should also be encouraged where possible. We have experienced a case of pseudomembranous colitis in a 4-year-old female presented with septic shock and colitis. This case was diagnosed with positive test of C. difficile toxin B and confirmed by isolation of the organism on cultire in selective media. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metronidazole and oral vancomycin, and ICU care.

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A Case of Pseudomembranous Colitis (위막성 대장염 1례)

  • Chung, Moon-Kwan;Yang, Chang-Heon;Lee, Heon-Ju;Lee, Young-Hyun;Kim, Chong-Suhl;Choi, Won-Hee
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.171-178
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    • 1984
  • Many reports have been made concerning underlying and associated conditions causing pseudomembranous colitis and it has been documented that occurrence of pseudomembranous colitis is related with antibiotics administration. Recent study showed that Clostridium difficile produced enterotoxin by colonization in intestinal wall and leading into pseudomembranous colitis. Diagnosis is based on positive culture of Clostridium difficile, positive test of Clostridium difficile toxin and specific histological findings after observation of whitish plaque on colonoscopic or sigmoidoscopic examination. Authors have experienced one case of pseudomembranous colitis developing after long term ampicillin administration in a case with colon cancer associated with diarrhea and diagnosis was confirmed by typical pseudomembrane on biopsy following classical whitish plaque observation on sigmoidoscopic examination. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metronidazole in four days and disappearance of whitish plaque on repeated sigmoidoscopic examination and improvement of clinical symptoms after 9 days of medication.

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Effects of Shirhyung-Tang in Two Stroke Patients with Pseudomembranous Colitis (장염을 동반한 뇌졸중환자의 시령탕을 이용한 호전 2례)

  • 노기환;정기현;조기호;김영석
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.179-188
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    • 2001
  • Diarrhea is the frequent passage of loose, watery stool (frequency: ${\geq}4/day$, weight: ${\geq}250g/day$) Most antibiotics can cause inflammatory change of the colon or Pseudomembranous colitis (PMC). Typical presentations of PMC are watery diarrhea, abdominal pain, fever, leukocytosis ($12,000~20,000/\textrm{mm}^3$), hypoalbuminemia, hypovolemia and recent or concurrent use of antibiotics. Diagnostic methods of PMC are stool assay, sigmoid scopy, abdominal CT, abdominal US, etc. The age-related susceptibility noted with PMC is impressive but unexplained. Two stroke patients had diarrhea, abdominal pain, fever hypoalbuminemia and a history of recent or concurrent use of antibiotics. By use of Shirhyung- Tang, we could improve clinical symptoms (diarrhea, abdominal pain, fever hypoalbuminemia, etc.) and so report clinical course of two stroke patients with antibiotics-associated PMC.

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A Case of Pseudomembranous Necrotizing Bronchial Aspergillosis in An Old Age Host (노인 환자에서 발생한 거짓막 괴사성 기관지 아스페르길루스증 1예)

  • Lee, Seung Eun;Jun, Eun Ju;Song, Ju Han;Shin, Jong Wook;Kim, Jae Yeol;Park, In Whon;Choi, Byoung Whui;Choi, Jae Chol;Kim, Mee Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.3
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    • pp.278-282
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    • 2007
  • Invasive aspergillus tracheobronchitis is uncommon manifestation of infection due to Aspergillus species, occurring in severely immunocompromised patients who are generally neutropenic with haematological diseases, AIDS, or after heart and lung transplantation. The pseudomembranous form is the most severe condition and is usually fatal despite treatment with antifungal agents. However, there are a few cases reported with no apparent severe compromise in the host defences. We encountered a pseudomembranous necrotizing bronchial aspergillosis in a 73-year old male patient, who was treated successfully with antifungal agents.

A Case of Severe Pseudomembranous Tracheobronchitis Complicated by Co-infection of Influenza A (H1N1) and Staphylococcus aureus in an Immunocompetent Patient

  • Park, Sung Soo;Kim, Seung Hoon;Kim, Mihee;Kim, Jong Wook;Ko, Yoo Mi;Kim, Sung-Kyoung;Kim, So Hyang;Kim, Chi Hong
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.366-370
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    • 2015
  • Although influenza A (H1N1) virus leads to self-limiting illness, co-infection with bacteria may result in cases of severe respiratory failure due to inflammation and necrosis of intra-airway, as pseudomembranous tracheobronchitis. Pseudomembranous tracheobronchitis is usually developed in immunocompromised patients, but it can also occur in immunocompetent patients on a very rare basis. We report a case of pseudomembranous tracheobronchitis complicated by co-infection of inflenaza A and Staphylococcus aureus, causing acute respiratory failure in immunocompetent patients.

Pseudomembranous Colitis in a Child of Chronic Diarrhea (만성 설사 환아에서의 위막성 대장염 1례)

  • Lee, Jin;Kim, Jong-Wan;Kim, Seung-Il
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.138-143
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    • 1998
  • Chronic diarrhea in children is a common problem with numerous causes. Although most of these causes are benign, critical illness may present as chronic diarrhea. In a patient of chronic diarrhea, gastrointestinal infections are the most common causes in children of all ages and antibiotics may cause chronic diarrhea by altering intestinal microflora, which can result in the emergence of bacterial overgrowth. Overgrowth of Clostridium difficile may cause pseudomembranous colitis. We experienced 25-month-old boy who suffered from chronic diarrhea and partially treated with antibiotics irregularly. Colonoscopic findings of this child showed multiple plaques with white to yellowish exudate which adhere to the mucosal surface of a variable length of rectum. Histollogically, each plaque comprised a pseudomembrane of mucous debris, inflammatory cells, and exudate overlying groups of partially disrupted glands. A latex agglutination test on patient's stool was positive to toxin A of Clostridium difficile. He was recovered after stopping the antibiotics he has been prescribed, and being given vancomycin for 2 weeks. We report this case with brief review of literature.

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Refractory Clostridium difficile Infection Cured With Fecal Microbiota Transplantation in Vancomycin-Resistant Enterococcus Colonized Patient

  • Jang, Mi-Ok;An, Jun Hwan;Jung, Sook-In;Park, Kyung-Hwa
    • Intestinal research
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    • v.13 no.1
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    • pp.80-84
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    • 2015
  • The rates and severity of Clostridium difficile infections, including pseudomembranous colitis, have increased markedly. However, there are few effective treatments for refractory or recurrent C. difficile infections and the outcomes are poor. Fecal microbiota transplantation is becoming increasingly accepted as an effective and safe intervention in patients with recurrent disease, likely due to the restoration of a disrupted microbiome. Cure rates of >90% are being consistently reported from multiple centers. We cured a case of severe refractory C. difficile infection with fecal microbiota transplantation in a patient colonized by vancomycin-resistant enterococcus.

Ischemic colitis complicated by Clostridioides difficile infection treated with fecal microbiota transplantation

  • Seok Hyung Kang;Tae-Geun Gweon;Hyunjung Hwang;Myong Ki Baeg
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.666-670
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    • 2023
  • Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

The American Cockroach Peptide Periplanetasin-2 Blocks Clostridium Difficile Toxin A-Induced Cell Damage and Inflammation in the Gut

  • Hong, Ji;Zhang, Peng;Yoon, I Na;Hwang, Jae Sam;Kang, Jin Ku;Kim, Ho
    • Journal of Microbiology and Biotechnology
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    • v.27 no.4
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    • pp.694-700
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    • 2017
  • Clostridium difficile, which causes pseudomembranous colitis, releases toxin A and toxin B. These toxins are considered to be the main causative agents for the disease pathogenesis, and their expression is associated with a marked increase of apoptosis in mucosal epithelial cells. Colonic epithelial cells are believed to form a physical barrier between the lumen and the submucosa, and abnormally increased mucosal epithelial cell apoptosis is considered to be an initial step in gut inflammation responses. Therefore, one approach to treating pseudomembranous colitis would be to develop agents that block the mucosal epithelial cell apoptosis caused by toxin A, thus restoring barrier function and curing inflammatory responses in the gut. We recently isolated an antimicrobial peptide, Periplanetasin-2 (Peri-2, YPCKLNLKLGKVPFH) from the American cockroach, whose extracts have shown great potential for clinical use. Here, we assessed whether Peri-2 could inhibit the cell toxicity and inflammation caused by C. difficile toxin A. Indeed, in human colonocyte HT29 cells, Peri-2 inhibited the toxin A-induced decrease in cell proliferation and ameliorated the cell apoptosis induced by this toxin. Moreover, in the toxin A-induced mouse enteritis model, Peri-2 blocked the mucosal disruption and inflammatory response caused by toxin A. These results suggest that the American cockroach peptide Peri-2 could be a possible drug candidate for addressing the pseudomembranous colitis caused by C. difficile toxin A.