Pseudomembranous colitis

August 2017


Definition


Pseudomembranous colitis is an inflammation of the colon due to an infection after an antibiotic treatment. All antibiotics may trigger pseudomembranous colitis, characterized by the presence of small membranes in the stool. In the case of pseudomembranous colitis, the presence of the toxin "Clostridium" is found in the stool. This type of colitis is iatrogenic (i.e. drug-induced) and appears over a period of 3 days after the onset of antibiotic to up to one month after stopping treatment.

Symptoms


Pseudomembranous colitis is characterized, in addition to the presence of "Clostridium " in the stool, by:
  • the rapid onset of diarrhea, sometimes greenish, accompanied by dehydration,
  • stools that contain mucus and include fragments of the intestinal mucosa (the pseudomembranes)
  • abdominal pain,
  • nausea and vomiting,
  • a decline in general health.

Diagnosis


Pseudomembranous colitis is suspected when a patient shows the symptoms mentioned above. These symptoms are especially marked if a severe form of the disease develops. The diagnosis of pseudomembranous colitis is essentially confirmed by a colonoscopy (visual examination of the colon performed under general anesthesia) that finds a yellowing of membranes along the colon walls. A diagnosis may also be made by observing a stool sample (enzyme-linked immunosorbent assay). The latter may underline the presence of a particular antigen or toxin.

Treatment


Treatment begins with the discontinuation of the antibiotic causing pseudomembranous colitis (this alone is often enough to cure 25% of patients within 3 days). If this is not enough, medication can be given - metronidazole or vanomycine - for 10 days under medical supervision. The most severe forms of pseudomembranous colitis require transfer to an intensive care unit, and occasionally surgery to remove part of the colon.

Prevention


Prevention is first and foremost a rational use of antibiotics. Good hygiene with avid hand washing and the disinfection of one's environment are also preventive.

Related

Original article published by . Translated by Jeff. Latest update on June 22, 2013 at 06:14 AM by Jeff.
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