[Segmental necrotizing colitis in a patient with E. coli O104:H4 infection].

Abstract:

:A 29-year-old man presented with abdominal cramps and bloody diarrhoea. Blood tests revealed elevated C-reactive protein (21.3 mg/dL; normal range 0.01 - 0. 82 mg/dL) and white blood cells (28200/μL, normal range 4000 - 10000/μL). Stool tests were negative for enteropathogenic bacteria and Clostridium difficile toxins A/B. Ultrasound and computed tomography showed massive swelling of the transverse colon and right colonic flexure. At endoscopy, circular necrosis of the mucosa was encountered in the proximal segments of the colon whereas distal parts of the organ showed patchy inflammation of minor severity. Extended stool testing identified Escherichia coli type O104:H4 as the causative microorganism. There was no evidence for haemolytic uraemic syndrome. Under conservative treatment the patient recovered clinically, serologically and endoscopically. At follow-up endoscopy, longitudinal ulcers and vital mucosa were present. In this case report the segmental pattern of mucosal necrosis in a patient with EHEC infection is noteworthy.

journal_name

Z Gastroenterol

authors

Scheppach W,Reissmann N,Breunig E,Konwisorz A,Schwarz TF,Müller JG,Tappe D

doi

10.1055/s-0031-1299289

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

209-12

issue

2

eissn

0044-2771

issn

1439-7803

journal_volume

50

pub_type

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