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The Clostridium difficile is the etiologic agent most often isolated in patients with antibiotic-associated colitis. Rarely this symptomatology is complicated by postinfection arthritis. The following describes 2 cases of acute colitis by clostridium difficile associated with acute polyarthritis.
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Explore the source record for details and available documents.
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C. difficile is a frequent cause of nosocomial diarrhea and is associated with substantial morbidity. C. difficile carriage may arise either from overgrowth of endogenous organisms or from exogenous acquisition. Within hospitals, asymptomatically colonized patients typically outnumber symptomatic patients by a ratio of approximately 3:1. Patient-to-patient transmission of C. difficile has been well documented in studies of nosocomial outbreaks, utilizing typing methods to supplement epidemiologic investigations. The mechanisms and frequency of transmission probably vary between institutions, but contamination of environmental surfaces and personnel hand carriage both appear to be important. Nosocomial C. difficile infection can be remarkably difficult to control, particularly after it becomes endemic in an institution. Policies targeting both environmental contamination and personnel hand-washing/glove use practices may be most successful. Prophylaxis of C. difficile diarrhea in high-risk patients on antibiotics may also have merit if an effective and safe biologic agent can be identified. Asymptomatically colonized patients should not be treated because they are at low risk for the development of diarrhea and because further antibiotic treatment may prolong the carrier state.
39 patients with colon bowel inflammatory by C. difficile infection after antibioticotherapy were treated. The causes of antibioticotherapy most frequently former infection of the upper respiratory tract. The C. difficile infection were most frequently before therapy: poliantibiotics, Cephalosporins II generations and Linkomycin. In diagnosis of C. difficile infection the Enzyme Immuno-Fluorescence Test were practical utility confirmed. The symphtomaticotherapy patients with slight course of ills were sufficiently. The therapy of Metronidazol or/and Colestyramine in patients with mild or highly course of ills were efficacious.
Detection rate of G. intestionalis in feces with direct microscopy has been compared with the immuno-enzymatic technique detecting protein GSA 65 with Alexon Inc., ProSpec T/Giardia reagents kit. The results obtained with both methods have further been compared with those obtained by microscopic examination of the duodenal content. Detectability of Giardia intestinalis with EIA technique with the use of ready-made kit has been assessed. Feces have been collected from 371 patients. Protein GSA 65 has been present in 170 samples, 45.8%, examined with the use of ProSpec T/Gardia kit. Giardia intestinalis cysts have been detected microscopically in the feces of 37 patients, i.e. in 22.3%. Microscopic examinations carried out by three independent examiners have shown marked diversity in the rate of positive results, being 0.1% (examiner A), 28.6% (B), and 45.2% (C). Comparison of G. intestinale detectability of all 3 techniques used have shown absence of protein GSA 65 in 2 out of 9 examined patients. However, trophozoits have been present in the duodenal content. Test performed with kits made by Alexon Inc. and DIALAB have given 45.8% and 60.7% of the positive results, respectively.
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Endophthalmitis is a severe condition caused by inflammation of the ocular cavity that often is associated with infection of the internal structures of the eye. The source of infection can include bacteria disseminated through the bloodstream and contamination of the cornea at the time of ocular surgery or trauma. Complications include rapid, reversible vision loss that can progress quickly to panophthalmitis, requiring surgical removal of the eye. Clostridium perfringens, an anaerobic gram-positive bacillus found in soil and bowel flora, is an infrequent cause of endophthalmitis. Although the majority of cases are caused by penetrating injury with soil-contaminated foreign bodies, C. perfringens endophthalmitis has been reported in patients after cataract surgery. This report describes two cases of C. perfringens endophthalmitis that occurred within 24 hours after transplant of contaminated corneas. These cases demonstrate the potential for transmission of Clostridium infection from donor to recipient. Clinicians should be aware of potential infection risks associated with transplantation of corneal tissues and report any infections to the appropriate eye bank.
BACKGROUND: Enterotoxigenic Clostridium perfringens type A is the third leading cause of foodborne disease in the United States, resulting annually in an estimated 250,000 cases of a typically mild, self-limiting gastrointestinal illness. METHODS: A retrospective cohort study was conducted to determine the cause of a small cluster of cases of gastrointestinal illness, which included cases of severe necrotizing colitis. Participants in the study consisted of residents and staff of a residential care facility for the mentally ill in Oklahoma (n = 20). An inspection of food preparation and food storage areas of the residential care facility was conducted as part of an environmental investigation. The investigation included extensive microbiological and molecular testing of the C. perfringens isolates and tissue specimens collected at autopsy. RESULTS: A total of 7 (3 confirmed and 4 probable) cases of foodborne enterotoxigenic C. perfringens type A were identified (attack rate, 35%) after the consumption of high-risk foods. Three residents developed acute necrotizing colitis; 2 of them died. Each patient with confirmed infection presented with evidence of constipation or fecal impaction. C. perfringens enterotoxin (CPE)-positive C. perfringens type A was cultured on samples from each patient with necrotizing colitis. Although statistical analyses failed to implicate a food source, the isolates carried a chromosomal cpe gene, which supports a foodborne origin. CONCLUSIONS: This study confirms that foodborne CPE-positive C. perfringens type A can affect the colon, resulting in potentially fatal necrotizing colitis. Drug-induced constipation and fecal impaction, resulting in prolonged exposure of the colonic mucosal tissue to C. perfringens type A toxins, contributed to the development of necrotizing colitis.
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Eighty-eight episodes of wound associated infection were identified among 624 consecutively admitted battlefield casualties. Ninety-one per cent of infections occurred during the administration of antibiotic therapy or prophylaxis and 65% were associated with the use of multiple antibacterial agents. Gram negative bacillary and mixed microbial infection predominated and were found to increase in relative incidence after the second day of hospitalization. Appropriate therapy, based on disc sensitivity testing, was administered in only 33% of infectious episodes. The practice of antibiotic wound prophylaxis may contribute to the incidence and nature of infection in battlefield wounds. Problems unique to the handling of battlefield wounded are discussed in comparing the present data with those of other war associated and civilian studies.