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Toxic megacolon

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https://www.readbyqxmd.com/read/28403672/toxic-megacolon-as-a-rare-complication-following-atropine-therapy-due-to-organophosphate-poisoning-a-case-report
#1
Babak Mostafazadeh, Esmaeil Farzaneh, Maryam Paeezi, Farahnaz Nikkhah
The main therapeutic basis for a case of organophosphate poisoning is a combination therapy which includes atropine as an anticholinergic drug and pralidoxime. If the poisoning is severe, a high dose of this combination of medicines may be needed, but this may cause serious side effects: paralytic ileus or even megacolon; however, these gastrointestinal events are very rare. Here, we report a case of organophosphate poisoning where atropine therapy was given and led to drug-associated toxic megacolon.
January 1, 2017: Medico-legal Journal
https://www.readbyqxmd.com/read/28396132/clostridium-difficile-infection
#2
REVIEW
Luis Alcalá Hernández, Elena Reigadas Ramírez, Emilio Bouza Santiago
Clostridium difficile infection (CDI) is the main cause of nosocomial diarrhea in industrialized countries and the source of a growing number of cases of diarrhea in the community. The outbreak of the hypervirulent strain belonging to ribotype 027 has increased the incidence and severity of CDI in some countries. Although CDI usually courses as a mild diarrhea it can lead to severe forms such as toxic megacolon or septic shock. One of every 2 episodes of CDI is not diagnosed in Spanish hospitals due to a lack of clinical suspicion or the use of insensitive diagnostic methods...
April 8, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28348903/successful-treatment-of-clostridium-difficile-bacteremia-with-aortic-mycotic-aneurysm-in-a-patient-with-prior-endovascular-aortic-aneurysm-repair
#3
Kairav Shah, Rebecca Brauch, Kartikeya Cherabuddi
The clinical spectrum of Clostridium difficile infection can range from benign gastrointestinal colonization to mild diarrhea and life threatening conditions such as pseudomembranous colitis and toxic megacolon. Extraintestinal manifestations of C. difficile are rare. Here, we report a patient with a history of an endovascular aortic aneurysm repair (EVAR) presenting with an endovascular leak complicated by C. difficile bacteremia and a mycotic aneurysm. He was successfully treated with an explant of the EVAR, an aorto-left renal bypass, and aorto-bi-iliac bypass graft placement along with a six-week duration of intravenous vancomycin and oral metronidazole...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28238232/is-abdominal-ct-scan-useful-for-the-management-of-patients-with-severe-acute-colitis-complicating-inflammatory-bowel-disease-a-study-in-54-consecutive-patients
#4
Diane Mege, Marie Monsinjon, Magaly Zappa, Carmen Stefanescu, Xavier Treton, Léon Maggiori, Yoram Bouhnik, Yves Panis
AIM: To evaluate the contribution of CT scanning to the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD), in particular, its contribution to surgical decision making. METHOD: All patients who were admitted to our institution for SAC complicating IBD, were divided into Group A (surgical treatment) and B (medical treatment). Admission CT scan results were compared between the 2 groups. RESULTS: From 2006 to 2015, 54 patients (26 males, median age= 39 (17-71) years) presented with SAC were divided into Group A (n=41, 76%) and B (n=13, 24%)...
February 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28208866/fatal-toxic-megacolon-in-a-child-of-hirschsprung-disease
#5
Shiwani R Garg, Pragati A Sathe, Annapurna C Taware, Ketaki M Surve
Hirschsprung disease (HD) in late childhood is uncommon and often undiagnosed or misdiagnosed. However, in a patient with Hirschsprung disease, of greater significance is the occurrence of life threatening enterocolitis. In its more severe form, this is associated with gross dilatation of the colon and profound toxaemia, the combination being termed toxic megacolon. Because of its relative rarity, we report a case of 10-year-old child who had a history of chronic constipation for nine years. He later developed complications and presented to the emergency department with toxic megacolon, a rare occurrence due to neglected constipation...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28161256/cecal-perforation-associated-with-clostridium-difficile-infection-a%C3%A2-case-report
#6
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Various complications are reported with Clostridium difficile infection (CDI), including fulminant CDI. Fulminant CDI is an underappreciated life-threatening condition associated with complications such as toxic megacolon and bowel perforation. CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage. While hospitalized, she developed watery diarrhea due to Clostridium difficile...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28090493/toxic-megacolon-and-interstitial-pneumonia-caused-by-cytomegalovirus-infection-in-a-pediatric-patient-with-acute-lymphoblastic-leukemia-receiving-chemotherapy
#7
Hyunseop Kwon, Hyun Hee Lee, Chung Ryul Paik, Yun-Jeong Lim, Jeong A Park
No abstract text is available yet for this article.
December 2016: Blood Research
https://www.readbyqxmd.com/read/27997854/the-emerging-metabolic-view-of-clostridium-difficile-pathogenesis
#8
REVIEW
Andrew J Hryckowian, Kali M Pruss, Justin L Sonnenburg
It is widely accepted that Clostridium difficile exploits dysbiosis and leverages inflammation to thrive in the gut environment, where it can asymptomatically colonize humans or cause a toxin-mediated disease ranging in severity from frequent watery diarrhea to pseudomembranous colitis or toxic megacolon. Here, we synthesize recent findings from the gut microbiota and enteric pathogenesis fields to inform the next steps toward a better understanding of C. difficile infection (CDI). In this review, we present a model in which the lifestyle of C...
December 17, 2016: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/27796474/-clostridium-difficile-infection-what-is-currently-available-for-treatment
#9
A Stallmach
Clostridium difficile (C. difficile) is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus. It is transmitted via a fecal-oral route and can be found in 1-3 % of the healthy population. Symptoms caused by C. difficile range from uncomplicated diarrhea to a toxic megacolon. The incidence, frequency of recurrence, and mortality rate of C. difficile infections (CDIs) have increased significantly over the past few decades. The most important risk factor is antibiotic treatment in elderly patients and patients with severe comorbidities...
December 2016: Der Internist
https://www.readbyqxmd.com/read/27759787/management-of-acute-severe-ulcerative-colitis-a-clinical-update
#10
REVIEW
Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27755271/the-use-and-efficacy-of-fecal-microbiota-transplantation-for-refractory-clostridium-difficile-in-patients-with-inflammatory-bowel-disease
#11
Robert J Gianotti, Alan C Moss
Clostridium difficile (CD) is an anaerobic, spore-forming bacillus that is responsible for a spectrum of gastrointestinal illness ranging from asymptomatic carriage to toxic megacolon and death. The prevalence of CD infection is increasing in both hospitalized and community-based inflammatory bowel disease populations. Standard antibiotic therapy fails to cure or prevent recurrence in more than 50% of patients, thus increasing the need for alternative therapies. Recently, fecal microbiota transplantation has received renewed attention as a therapy for refractory or recurrent CD infection...
November 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27721723/tacrolimus-therapy-for-three-patients-with-elderly-onset-ulcerative-colitis-report-of-three-cases
#12
Rumiko Kobayashi, Satohiro Matsumoto, Yukio Yoshida
In recent years, cases of elderly-onset ulcerative colitis (UC) have been increasing in number and are currently reported to account for 10-15% of all cases of UC. Although the treatment of UC is essentially similar between older and younger patients, evidence of the therapeutic efficacy of tacrolimus in elderly-onset UC patients is still limited. Herein, we report our attempt to induce remission using tacrolimus in three patients with elderly-onset UC. A 75-year-old Japanese woman, a 71-year-old Japanese man and a 76-year-old Japanese woman with severe elderly-onset UC of the pancolitis type were treated with tacrolimus...
May 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27717398/rapid-change-of-fecal-microbiome-and-disappearance-of-clostridium-difficile-in-a-colonized-infant-after-transition-from-breast-milk-to-cow-milk
#13
Manli Y Davis, Husen Zhang, Lera E Brannan, Robert J Carman, James H Boone
BACKGROUND: Clostridium difficile is the most common known cause of antibiotic-associated diarrhea. Upon the disturbance of gut microbiota by antibiotics, C. difficile establishes growth and releases toxins A and B, which cause tissue damage in the host. The symptoms of C. difficile infection disease range from mild diarrhea to pseudomembranous colitis and toxic megacolon. Interestingly, 10-50 % of infants are asymptomatic carriers of C. difficile. This longitudinal study of the C. difficile colonization in an infant revealed the dynamics of C...
October 7, 2016: Microbiome
https://www.readbyqxmd.com/read/27614338/campylobacter-colitis-rare-cause-of-toxic-megacolon
#14
Michael Kwok, Andrew Maurice, Carl Lisec, Jason Brown
INTRODUCTION: Campylobacter is the leading cause of bacterial diarrhoeal illness worldwide. Toxic megacolon is a rare but potentially devastating complication. PRESENTATION OF CASE: A 55year old female with liver cirrhosis, alcoholism and hepatitis C, presented with severe colitis and stool specimen positive for Campylobacter. She developed septic shock, multi-organ dysfunction syndrome and toxic megacolon unresponsive to medical therapy, and underwent a subtotal colectomy with end ileostomy...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27599690/use-of-intravenous-tigecycline-in-patients-with-severe-clostridium-difficile-infection-a-retrospective-observational-cohort-study
#15
B Gergely Szabo, B Kadar, K Szidonia Lenart, B Dezsenyi, P Kunovszki, K Fried, K Kamotsay, R Nikolova, G Prinz
There are only a limited number of antimicrobials for treating severe Clostridium difficile infection (sCDI). Tigecycline shows significant in vitro effect against C. difficile and is approved for management of complicated intra-abdominal infections. Our aim was to analyse the efficacy of tigecycline compared with standard therapy (oral vancomycin plus intravenous metronidazole) in adults treated for sCDI. A retrospective cohort study of such patients hospitalized at our department from January 2014 to December 2015 was performed...
December 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27441530/-nonspecific-ulcerative-colitis-complicated-with-multiple-repetitive-perforations-and-diffuse-fecalic-peritonitis-case-report
#16
A Antadze, G Mukhashavria, N Lekvtadze, G Tomadze, G Chikobava
Nonspecific ulcerative colitis is disease with complicated and not fully studied etiology and pathogenesis, and treatment of its complications is very difficult. Especially complicated is disease course with repetitive bleeding, toxic megacolon and perforation. We present a quite rare case of complication with multiple, especially repetitive perforations of transverse colon. After 13 days from the performance of subtotal colectomy, the patient underwent to the relaparotomy because of secondary perforation of sygmoid colon 2-3 cm lower from its cult and iliac intestine 0...
June 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27413067/a-tetraspecific-vhh-based-neutralizing-antibody-modifies-disease-outcome-in-three-animal-models-of-clostridium-difficile-infection
#17
Diane J Schmidt, Gillian Beamer, Jacqueline M Tremblay, Jennifer A Steele, Hyeun Bum Kim, Yaunkai Wang, Michele Debatis, Xingmin Sun, Elena A Kashentseva, Igor P Dmitriev, David T Curiel, Charles B Shoemaker, Saul Tzipori
Clostridium difficile infection (CDI), a leading cause of nosocomial infection, is a serious disease in North America, Europe, and Asia. CDI varies greatly from asymptomatic carriage to life-threatening diarrhea, toxic megacolon, and toxemia. The incidence of community-acquired infection has increased due to the emergence of hypervirulent antibiotic-resistant strains. These new strains contribute to the frequent occurrence of disease relapse, complicating treatment, increasing hospital stays, and increasing morbidity and mortality among patients...
September 2016: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/27388627/the-efficacy-of-intracolonic-vancomycin-for-severe-clostridium-difficile-colitis-a-case-series
#18
Christine M Akamine, Michael B Ing, Christian S Jackson, Lawrence K Loo
BACKGROUND: Clostridium difficile infection (CDI) unresponsive to the standard treatments of metronidazole and oral vancomycin requires aggressive medical management and possible surgical intervention including colectomy. Intracolonic vancomycin therapy has been reported to be particularly promising in the setting of severe CDI in the presence of ileus. This is a descriptive case series exploring the effect of adjunctive intracolonic vancomycin therapy on the morbidity and mortality in patients with moderate to severe CDI...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27281569/viral-spread-to-enteric-neurons-links-genital-hsv-1-infection-to-toxic-megacolon-and-lethality
#19
William Khoury-Hanold, Brian Yordy, Philip Kong, Yong Kong, William Ge, Klara Szigeti-Buck, Alexandra Ralevski, Tamas L Horvath, Akiko Iwasaki
Herpes simplex virus 1 (HSV-1), a leading cause of genital herpes, infects oral or genital mucosal epithelial cells before infecting the peripheral sensory nervous system. The spread of HSV-1 beyond the sensory nervous system and the resulting broader spectrum of disease are not well understood. Using a mouse model of genital herpes, we found that HSV-1-infection-associated lethality correlated with severe fecal and urinary retention. No inflammation or infection of the brain was evident. Instead, HSV-1 spread via the dorsal root ganglia to the autonomic ganglia of the enteric nervous system (ENS) in the colon...
June 8, 2016: Cell Host & Microbe
https://www.readbyqxmd.com/read/27241781/bile-acid-sensitivity-and-in%C3%A2-vivo-virulence-of-clinical-clostridium-difficile-isolates
#20
Brittany B Lewis, Rebecca A Carter, Eric G Pamer
Clostridium difficile is an anaerobic bacterium that causes diarrheal illnesses. Disease onset is linked with exposure to oral antibiotics and consequent depletion of secondary bile acids. Here we investigate the relationship between in vitro secondary bile acid tolerance and in vivo disease scores of diverse C. difficile strains in mice.
October 2016: Anaerobe
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