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Superimposed Infectious Colitis in Crohn's Disease.
Matthew A Crain1, Justin T Kupec2
1West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Case Reports in Gastroenterology
|October 7, 2021
Summary
Differentiating acute Crohn's disease flares from enteric infections is crucial for treatment. This case highlights Plesiomonas shigelloides as a rare cause of infection in Crohn's disease patients, emphasizing the need for comprehensive stool testing.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Acute flares of Crohn's disease (CD) require careful differential diagnosis to distinguish from infectious causes.
- Enteric infections can mimic CD flares, complicating therapeutic decisions.
- Biologic therapy in moderate-to-severe CD may increase susceptibility to infections.
Observation:
- A patient with chronic Crohn's disease presented with symptoms suggestive of a flare.
- Comprehensive stool microbial testing revealed an unusual enteric infection.
- The infection was caused by Plesiomonas shigelloides, previously unreported in CD.
Findings:
- Prompt identification of Plesiomonas shigelloides infection through stool testing was achieved.
- Appropriate antibiotic treatment led to the resolution of the patient's acute symptoms.
- This represents the first documented case of Plesiomonas shigelloides infection in a Crohn's disease patient.
Implications:
- Highlights the importance of microbial stool analysis in the differential diagnosis of acute Crohn's flares.
- Suggests Plesiomonas shigelloides as a potential pathogen in immunocompromised patients, including those on biologics.
- Underscores the need for awareness of rare enteric pathogens in managing inflammatory bowel disease.
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