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Unusual Colon Infections
Diseases and pathological conditions involving the colon (Figures 1A and 1B; click on the link below Figure 1A to manipulate the colon model from the Visible Human database) are commonly seen in a gastroenterology practice. Infectious processes account for a significant proportion of the abnormalities which are uncovered. Infection with Clostridium difficile, for example, can occur in up to 10% of patients in a tertiary care hospital (1-3). An example of a Clostridium difficile infection of the colon is shown in Video Clip 1.
This issue of VHJOE contains two cases of the more unusual colonic infections that one can find, each of which masquerading as a non-infectious entity. Drs. Fabor, Suthun and McNally describe an infection which was causing symptoms felt to be due to irritable bowel syndrome, whereas Drs. Chen and Savides uncovered an infectious process which had created a mass concerning for a neoplastic process. These cases highlight how important it is for endoscopists to be aware of the common and the unusual when evaluating patients, and to be liberal with biopsies to make sure a proper diagnosis is established.
References
1. Samore MH, DeGirolami PC, Tlucko A, Lichtenberg DA, Melvin ZA, Karchmer AW. Clostridium difficile colonization and diarrhea at a tertiary care hospital. Clin Infect Dis. 1994 Feb;18(2):181-7.
2. Barbut F, Corthier G, Charpak Y, Cerf M, Monteil H, Fosse T, Trevoux A, De Barbeyrac B, Boussougant Y, Tigaud S, Tytgat F, Sedallian A, Duborgel S, Collignon A, Le Guern ME, Bernasconi P, Petit JC. Prevalence and pathogenicity of Clostridium difficile in hospitalized patients. A French multicenter study. Arch Intern Med. 1996 Jul 8;156(13):1449-54.
3. Shehabi AA, Abu-Ragheb HA, Allaham NA. Prevalence of Clostridium difficile-associated diarrhoea among hospitalized Jordanian patients. East Mediterr Health J. 2001 Jul-Sep;7(4-5):750-5.
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