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pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma

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World Journal of Gastroenterology 2005年第17期11卷 2681-2683页

作者： Kenichi Nomura Kohei Fukumoto Daisuke Shimizu Takashi Okuda Naohisa Yoshida Yuri Kamitsuji Yosuke Matsumoto Hideyuki Konishi Yuji Ueda Shigeo Horiike Takeshi Okanoue Masafumi Taniwaki Department of Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Inflammation and Immunology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Division of Digestive Surgery Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Clinical Molecular Genetics and Laboratory MedicineKyoto Prefectural University of MedicineGraduate School of Medical ScienceKyotoJapan

pseudomembranous colitis (PMC) usually manifests asfever and diarrhea in hospitalized patients treated withsystemic antibiotics. We described a case of PMC withintestinal obstruction but without diarrhea. A 60-yearold man was hospitalized for chemotherapy for the treatment of Burkitt lymphoma of the stomach. The patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. Plain abdominal radiography showed some intestinal gas and niveau. Because stool cytotoxin assay for clostridium difficile was positive and colon fiberscopic examination showed a pseudomembrane at the left side of the colon,and a diagnosis of PMC was made. Treatment with intracolonic vancomycin administration by colonoscopy and nasoileus tube was successful. Physicians should take into account the possibility of bowel obstruction due to PMC occurring in patients undergoing chemotherapy and perform emergency colonoscopy examination of suspected cases.

关键词： pseudomembranous colitis Ileus Vancomycin Chemotherapy Lymphoma

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Non-clostridium difficile induced pseudomembranous colitis

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World Journal of Clinical Cases 2023年第5期11卷 979-988页

作者： Gowthami Sai Kogilathota Jagirdhar Salim Surani Department of Medicine Saint Michaels Medical CenterNewarkNJ 07102United States Department of Pulmonary Critical Care&PharmacyTexas A&M UniversityKingsvilleTX 78363United States

pseudomembranous colitis is severe inflammation of the inner lining of the colon due to anoxia,ischemia,endothelial damage,and toxin *** majority of cases of pseudomembranous colitis are due to Clostridium ***,other causative pathogens and agents have been responsible for causing a similar pattern of injury to the bowel with the endoscopic appearance of yellow-white plaques and membranes on the mucosal surface of the *** presenting symptoms and signs include crampy abdominal pain,nausea,watery diarrhea that can progress to bloody diarrhea,fever,leukocytosis,and *** testing for Clostridium difficile or failure to improve on treatment should prompt evaluation for other causes of pseudomembranous *** infections other than Clostridium difficile,Viruses such as cytomegalovirus,parasitic infections,medications,drugs,chemicals,inflammatory diseases,and ischemia are other differential diagnoses to look out for in pseudomembranous *** of pseudomembranous colitis include toxic megacolon,hypotension,colonic perforation with peritonitis,and septic shock with organ *** diagnosis and treatment to prevent progression are *** central perspective of this paper is to provide a concise review of the various etiologies for pseudomembranous colitis and management per prior literature.

关键词： Infections pseudomembranous colitis Gastroenteritis Gastrointestinal diseases Non-Clostridium difficile Enterocolitis Digestive system diseases

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Immunological mechanisms of fecal microbiota transplantation in recurrent Clostridioides difficile infection

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World Journal of Gastroenterology 2022年第33期28卷 4762-4772页

作者： Lucas F Soveral Gabriela G Korczaguin Pedro S Schmidt Isabel S Nunes Camilo Fernandes Carlos R Zarate-Blades Laboratory of Immunoregulation Department of MicrobiologyImmunologyand ParasitologyCenter for Dysbiosis ControlFederal University of Santa CatarinaFlorianopolis 88037-000Brazil Division of Infectious Diseases Hospital Nereu RamosFlorianopolis 88025-301Brazil

Fecal microbiota transplantation(FMT)is a successful method for treating recurrent Clostridioides difficile(***)infection(rCDI)with around 90%*** to the relative simplicity of this approach,it is being widely used and currently,thousands of patients have been treated with FMT ***,the mechanisms underlying its effects are just beginning to be *** indicate that FMT effectiveness is due to a combination of microbiological direct mechanisms against ***,but also through indirect mechanisms including the production of microbiota-derived metabolites as secondary bile acids and short chain fatty ***,the modulation of the strong inflammatory response triggered by *** after FMT seems to rely on a pivotal role of regulatory T cells,which would be responsible for the reduction of several cells and soluble inflammatory mediators,ensuing normalization of the intestinal mucosal immune *** this minireview,we analyze recent advances in these immunological aspects associated with the efficacy of FMT.

关键词： Fecal microbiota transplantation Immunity Mechanism Dysbiosis pseudomembranous colitis Clostridioides difficile

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Recent developments on the role of Clostridium difficile in inflammatory bowel disease

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World Journal of Gastroenterology 2008年第18期14卷 2794-2796页

作者： Hugh James Freeman Department of Medicine (Gastroenterology) University of British Columbia Vancouver V6T 1W5Canada

Clostridium difficile (CD), specifically its toxins, have been implicated as a risk factor for exacerbation of the inflammatory process in up to 5% of patients with ulcerative colitis or Crohn’s disease. Typical evidence of colonic changes with CD infection, including pseudomembranous exudate, are often not present; however, a severe clinical course may result, including precipitation of toxic colitis and toxic megacolon. Recently, hypervirulent CD strains have been reported raising concern for a more severe disease process in patients with underlying inflammatory bowel ***, small bowel involvement or CD enteritis has been increasingly described, usually in those with a history of a prior colectomy or total proctocolectomy for prior severe and extensive inflammatory bowel disease. Finally, refractory or treatment-resistant pouchitis may occur with CD infection.

关键词： Crohn's disease Ulcerative colitis Antibiotic-associated colitis Cytotoxin Enterotoxin pseudomembranous colitis Clostridium difficile colitis

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Probiotics and the gastrointestinal tract:Where are we in 2005?

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World Journal of Gastroenterology 2006年第6期12卷 853-857页

作者： IritChermesh RamiEliakim Gastroenterology Department Rambam Medical Center.Haifa.Israel

Probiotic agents are live microbes or components of microbes that have a positive effect on the host. They exert their action through interplay with the immune system of the host. Some of this effect is local and some is systemic. The full story is yet to be discovered. Probiotics have a definite positive effect on rotavirus diarrhea, post antibiotic diarrhea and pouchitis. Their exact role in inflammatory bowel disease, irritable bowel syndrome, other forms of infectious diarrhea, and prevention of cancer is yet to be determined. This review summarizes the data about probiotics in these conditions.

关键词： Probiotics Inflammatory bowel disease Crohn's disease Lactose intolerance Antibiotic associated diarrhea Rotavirus pseudomembranous colitis Clostridium dificile Irritable bowel syndrome Toll like receptor 9

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