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Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid...
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Pseudomembranous colitis: Not always Clostridium difficile.

Derek M Tang1, Nathalie H Urrunaga2, Erik C von Rosenvinge2,3

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Cleveland Clinic Journal of Medicine
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This summary is machine-generated.

Pseudomembranous colitis is often caused by Clostridium difficile infection. However, consider other causes if testing is negative or treatment fails, as histology can reveal the true etiology.

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Area of Science:

  • Gastroenterology
  • Pathology
  • Infectious Diseases

Background:

  • Pseudomembranous colitis is frequently associated with Clostridium difficile infection.
  • Endoscopic findings of pseudomembranes warrant consideration of differential diagnoses.

Purpose of the Study:

  • To highlight the importance of considering alternative etiologies of pseudomembranous colitis beyond Clostridium difficile infection.
  • To emphasize the diagnostic utility of colonic mucosal biopsy histology.

Main Methods:

  • Review of clinical cases presenting with pseudomembranous colitis.
  • Endoscopic evaluation and C. difficile testing.
  • Histologic examination of colonic mucosal biopsy specimens.

Main Results:

  • Clostridium difficile infection is the most common cause of pseudomembranous colitis.
  • Negative C. difficile tests or treatment non-response suggest alternative diagnoses.
  • Histologic findings from biopsies can identify less common causes.

Conclusions:

  • Clinicians must consider non-C. difficile causes of pseudomembranous colitis.
  • Histologic review of colonic biopsies is crucial for diagnosing uncommon etiologies.
  • Prompt identification of the underlying cause ensures appropriate patient management.