Materiały źródłowe

• #1 Pseudomembranous colitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudomembranous-colitis/symptoms-causes/syc-20351434

  Pseudomembranous (SOO-doe-mem-bruh-nus) colitis is inflammation of the colon associated with an overgrowth of the bacterium Clostridioides difficile (formerly Clostridium difficile) often called C. diff. […] This overgrowth of Clostridioides difficile (C. difficile) is often related to a recent hospital stay or antibiotic treatment. […] Pseudomembranous colitis occurs when certain bacteria, usually C. difficile, rapidly outgrow other bacteria that typically keep them in check. Certain toxins produced by C. difficile can rise to levels high enough to damage the colon. […] While almost any antibiotic can cause pseudomembranous colitis, some antibiotics are more commonly linked to pseudomembranous colitis than others, including: […] Other medicines besides antibiotics can sometimes cause pseudomembranous colitis.

• #2 Pseudomembranous Colitis: What It Is, Symptoms, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17718-pseudomembranous-colitis

  Pseudomembranous colitis (PMC) is a severe form of colitis. In this condition, something attacks and injures your colon lining (mucosa). It might be bacteria, toxins or another illness. Your colon mucosa develops thickened, scab-like plaques over the wounds. Your healthcare provider might call these pseudomembranes. […] C. diff (Clostridioides difficile) infection is the most common cause of pseudomembranous colitis. C. diff is a bacterial infection that produces toxins that injure your colon lining. About 10% of C. diff infections progress to pseudomembranous colitis. This produces more than 90% of all cases. But other causes of colitis can also cause similar damage. […] C. difficile produces toxins that injure your colon mucosa, causing cell death. C. diff infection also can become unusually severe, unusually fast. C. diff infection usually happens after you’ve taken antibiotics. Antibiotics reduce the other bacteria in your gut, but they don’t affect C. diff. This allows C. diff to quickly grow out of control.

• #3 Pseudomembranous Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4402243/

  Pseudomembranous colitis is an inflammatory condition of the colon characterized by elevated yellow-white plaques that coalesce to form pseudomembranes on the mucosa. […] Because pseudomembranous colitis is often associated with C. difficile infection, stool testing and empiric antibiotic treatment should be initiated when suspected. […] The less common non-C. difficile causes of pseudomembranous colitis should be entertained, as a number of etiologies can result in this condition. Examples include Behcets disease, collagenous colitis, inflammatory bowel disease, ischemic colitis, other infections organisms (e.g. bacteria, parasites, viruses), and a handful of drugs and toxins. […] Pseudomembranous colitis (PMC) is a manifestation of severe colonic disease that is usually associated with Clostridium difficile infection, but can be caused by a number of different etiologies.

• #4 Pseudomembranous colitis: causes and cures – PubMed

  https://pubmed.ncbi.nlm.nih.gov/10095149/

  Clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract and has increased in frequency over time. […] Pseudomembranous colitis (PMC), the severest form of this disease, occurs as a result of a severe inflammatory response to the C. difficile toxins. […] Diagnosis rests on detection of C. difficile in the stool, either by culture, tissue culture assay for cytotoxin B or detection of antigens in the stool by rapid enzyme immunoassays. […] Recurrence of symptoms after antibiotics occurs in 20% of cases and is associated with persistence of C. difficile in the stools. […] Therapy with antibiotics in a pulsed or tapered regimen is often effective as are efforts to normalize the fecal flora.

• #5 Non-clostridium difficile induced pseudomembranous colitis

  https://www.wjgnet.com/2307-8960/full/v11/i5/979.htm

  Pseudomembranous colitis is severe inflammation of the inner lining of the colon due to anoxia, ischemia, endothelial damage, and toxin production. The majority of cases of pseudomembranous colitis are due to Clostridium difficile. However, other causative pathogens and agents have been responsible for causing a similar pattern of injury to the bowel with the endoscopic appearance of yellow-white plaques and membranes on the mucosal surface of the colon. […] Negative testing for Clostridium difficile or failure to improve on treatment should prompt evaluation for other causes of pseudomembranous colitis. Bacterial infections other than Clostridium difficile, Viruses such as cytomegalovirus, parasitic infections, medications, drugs, chemicals, inflammatory diseases, and ischemia are other differential diagnoses to look out for in pseudomembranous colitis.

• #6 Pseudomembranous Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4402243/

  Although CDI is the most common cause, other less common etiologies of PMC will be described. […] The pathophysiology of CDI has been studied extensively and appears to progress in a particular sequence. […] The common first step is the disruption of the normal colonic flora with subsequent C. difficile colonization. […] The clinical presentation of CDI is highly variable, ranging from the asymptomatic carrier to the patient with PMC, fulminant colitis, and toxic megacolon. […] The pathogenesis underlying the worse prognosis in IRCI is not clear; it has been postulated that the right colon, typically supplied by the SMA, is more sensitive to non-occlusive ischemia, as there is little collateral circulation and the vasa recta that supply the right colon initiate closer to the left colon and have to travel further to reach the right side.

• #7 Non-clostridium difficile induced pseudomembranous colitis

  https://www.wjgnet.com/2307-8960/full/v11/i5/979.htm

  Pseudomembranous colitis is an acute inflammation of the colon. It is primarily due to the overgrowth of the bacterium clostridium difficile and the production of toxins that damage the colonic mucosa. […] Over the years, other causes of pseudomembranous colitis have been increasingly identified. […] The absence of Clostridium Difficile on testing or failure of response to Clostridium difficile treatment in a patient with pseudomembranes on colonoscopy should encourage physicians to evaluate for other causes of colitis. […] Prior literature provides evidence of pseudomembranous colitis from inflammatory causes, non-clostridial infections, chemical agents, drugs, and ischemia. […] Symptoms of pseudomembranous colitis include watery diarrhea with pus or mucus in stool. This is the commonest symptom in the majority of patients, followed by abdominal pain/cramps and fever.

• #8 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  C difficile colitis results from a disruption of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation, mucosal damage, and diarrhea. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #9 Clostridioides difficile infection – Wikipedia

  https://en.wikipedia.org/wiki/Clostridioides_difficile_infection

  Causes Clostridioides difficile spread by the fecal-oral route. […] Risk factors for infection include antibiotic or proton pump inhibitor use, hospitalization, hypoalbuminemia, other health problems, and older age. […] Pathogenic C. difficile strains produce multiple toxins. […] Without either toxin A or toxin B, C. difficile may colonize the gut, but is unlikely to cause pseudomembranous colitis. […] The colitis associated with severe infection is part of an inflammatory reaction, with the „pseudomembrane” formed by a viscous collection of inflammatory cells, fibrin, and necrotic cells. […] Chronic kidney disease (CKD) has been identified as a risk factor in the development of a C. difficile infection. […] Patients with CKD have a higher risk of both initial and recurring infection, as well as a higher chance of severe infection, than those without CKD. […] The protective effects of serum albumin may be related to the capability of this protein to bind C. difficile toxin A and toxin B, thus impairing entry into enterocytes.

• #10 Pseudomembranous colitis

  https://adamcertificationdemo.adam.com/content.aspx?productid=141&isarticlelink=false&pid=1&gid=000259

  Pseudomembranous colitis refers to swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridioides difficile (C difficile) bacteria. […] This infection is a common cause of diarrhea after antibiotic use. Not all cases of diarrhea associated with antibiotic use are due to C difficile or will progress to pseudomembranous colitis. […] The C difficile bacteria normally lives in the intestine. However, too much of these bacteria may grow when you take antibiotic medicines. The bacteria give off a strong toxin that causes inflammation and bleeding in the lining of the colon. […] Any antibiotic can cause this condition. The medicines responsible for the problem most of the time are ampicillin, clindamycin, fluoroquinolones, and cephalosporins. […] Health care providers in the hospital may pass this bacteria from one patient to another.

• #11 Pseudomembranous Colitis: Causes, Symptoms, Treatment

  https://www.webmd.com/ibd-crohns-disease/ulcerative-colitis/pseudomembranous-colitis

  Pseudomembranous colitis (PMC) is inflammation in your colon that happens when there’s too much of certain bacteria in your system. The bacterium that causes PMC is Clostridium difficile, or C. diff. […] PMC is also called antibiotic-associated colitis or C. difficile colitis. Most of the time, it’s a side effect of taking antibiotics. […] The good bacteria in your colon usually keep the amount of C. diff in your body under control, but antibiotics can kill the healthy bacteria and let C. diff grow too fast. This damages your colon and causes PMC. […] While practically any antibiotic can cause it, some are more likely to cause PMC than others. These include: Cephalosporins (Cephalexin, Suprax), Clindamycin (Cleocin), Fluoroquinolones (Cipro, Levaquin), Penicillin (amoxicillin, ampicillin). […] PMC also can be related to: Changes in your diet, Chemotherapy, Hirschsprung disease (a condition that affects your colon), Kidney disease or kidney failure, Malnutrition, Recent bowel surgery, Shock.

• #12 Pseudomembranous colitis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/pseudomembranous-colitis

  Pseudomembranous colitis is inflammation of the colon associated with an overgrowth of the bacterium Clostridioides difficile (formerly Clostridium difficile) often called C. diff. […] This overgrowth of C. difficile is often related to a recent hospital stay or antibiotic treatment. […] Pseudomembranous colitis occurs when certain bacteria, usually C. difficile, rapidly outgrow other bacteria that typically keep them in check. Certain toxins produced by C. difficile can rise to levels high enough to damage the colon. […] While almost any antibiotic can cause pseudomembranous colitis, some antibiotics are more commonly linked to pseudomembranous colitis than others, including: Fluoroquinolones, such as ciprofloxacin (Cipro) and levofloxacin; Penicillins, such as amoxicillin and ampicillin; Clindamycin (Cleocin); Cephalosporins, such as cefixime (Suprax).

• #13 Pseudomembranous Colitis – The Gastrointestinalatlas – gastrointestinalatlas.com

  https://www.gastrointestinalatlas.com/english/pseudomembranous_colitis.html

  Fluoroquinolones, macrolides, clindamycin, beta-lactam/beta-lactamase inhibitors, and all 3 generations of cephalosporins have consistently been shown to pose a significant risk for the development of CDAD. […] Clostridium difficile colitis also may follow the use of certain cancer chemotherapy drugs. Pseudomembranous colitis has been reported as causing bloody diarrhea after chemotherapy. […] The frequency of pseudomembranous colitis with potential fatal outcome is underestimated especially in elderly patients. Proton pump inhibitors appear to increase the risk of acquiring CDC by reducing the acid concentration in the stomach and allowing the organism to pass unharmed into the intestine. […] Clostridium difficile-associated pseudomembranous colitis is an increasingly common nosocomial infection that usually responds to oral antibiotics.

• #14 Pseudomembranous Colitis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pseudomembranous-colitis

  Pseudomembranous colitis (PMC) is an acute, exudative colitis usually caused by Clostridioides difficile (C. difficile – formerly Clostridium difficile). PMC can rarely be caused by other bacteria – for example, Staphylococcus spp. or enterotoxigenic Clostridium perfringens, Campylobacter spp., Listeria spp. and Salmonella spp. […] The incidence of primary and recurrent CDI has increased around the world, even after considerable efforts in the last decade. Increased risk of primary CDI is due in part to increasing age of populations and increasing numbers of residents in long-term care facilities. Antibiotic overuse and the emergence of resistance to commonly-used antibiotics such as vancomycin are contributory factors to recurrent infections. […] Any antibiotic can increase the risk of CDI, including metronidazole and vancomycin, which are also used in the treatment of CDI.

• #15 Pseudomembranous Colitis – The Gastrointestinalatlas – gastrointestinalatlas.com

  https://www.gastrointestinalatlas.com/english/pseudomembranous_colitis.html

  Pseudomembranous colitis is a life-threatening complication of broad spectrum antibiotic therapy caused by Clostridium difficile. Untreated, the disease can lead to severe and in many cases fatal complications such as peritonitis due to colonic wall perforation, shock as a consequence of volume depletion, toxic megacolon and massive lower gastrointestinal haemorrhage. Fatal complications mostly occur in elderly people with a high degree of comorbidity. The risk of developing Clostridium difficile-induced colitis increases with age. […] Any antibiotic can increase the risk of C difficile disease, including metronidazole and vancomycin, which are used in the treatment of CDAD. Disease has been reported following as little as one dose of antibiotic. Although the attributable relative risk has varied among studies.

• #16 Pseudomembranous colitis: Not always Clostridium difficile | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/5/361

  Although Clostridium difficile infection is the cause of most cases of pseudomembranous colitis, clinicians should consider less common causes, especially if pseudomembranes are seen on endoscopy but testing remains negative for C difficile or if presumed C difficile infection does not respond to treatment. Histologic review of colonic mucosal biopsy specimens can provide clues to the underlying cause. […] Pseudomembranous colitis is most often due to Clostridium difficile infection, but it has a variety of other causes, including other infections, ischemia, medications, and inflammatory mucosal diseases. […] These less common causes are important to consider to avoid needlessly escalating anti-C difficile antibiotic therapy and to provide appropriate treatment. […] Pseudomembranous colitis is a nonspecific finding that suggests a larger disease process.

• #17 Pseudomembranous colitis: Not always Clostridium difficile | MDedge

  https://medauth2.mdedge.com/content/pseudomembranous-colitis-not-always-clostridium-difficile

  Pseudomembranous colitis is most often due to Clostridium difficile infection, but it has a variety of other causes, including other infections, ischemia, medications, and inflammatory mucosal diseases. When pseudomembranes are found, one should consider these other causes if tests for C difficile are negative or if anti-C difficile therapy does not produce a response. […] These less common causes are important to consider to avoid needlessly escalating anti-C difficile antibiotic therapy and to provide appropriate treatment. Pseudomembranous colitis is a nonspecific finding that suggests a larger disease process. […] A pseudomembrane is a layer of fibropurulent exudate composed of acute inflammatory cells and mucus originating from inflamed and erupting crypts. Although most often seen in C difficile infection, pseudomembranous colitis is a nonspecific pattern of injury resulting from decreased oxygenation, endothelial damage, and impaired blood flow to the mucosa that can be triggered by a number of disease states.

• #18 Pseudomembranous Colitis: What It Is, Symptoms, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/17718-pseudomembranous-colitis

  Other causes of colitis can also lead to pseudomembranous colitis, including: Staphylococcus aureus infection, E. coli infection, Cytomegalovirus infection, Microscopic colitis, Behets disease, Ischemic colitis, Chemotherapy drugs, Cocaine use, Vasculitis, Heavy metal poisoning. […] You’re more likely to develop pseudomembranous colitis if you: Are in a hospital, Recently took antibiotics, Recently had surgery, Are in a nursing home, Are older than 65, Have an autoimmune disease, Have a weakened immune system, Have had C. diff infection before.

• #19 Pseudomembranous Colitis Surgery: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/193031-overview

  Pseudomembranous colitis usually is associated with antibiotic use, which may alter the balance of normal gut flora and allow overgrowth of certain organisms. […] Clindamycin, lincomycin, ampicillin, and cephalosporin have been implicated in most of the reported cases, but any antimicrobial agent (including antifungal, antiviral, and metronidazole) could incite the disease, regardless of the amount administered or the route of administration. […] C difficile, a gram-positive, spore-forming, anaerobic bacillus, is isolated in almost all of these cases. […] Rare cases have been related to Staphylococcus aureus, Salmonella species, Clostridium perfringens, Yersinia species, Shigella species, Campylobacter species, cytomegalovirus, Entamoeba histolytica, and Listeria species. […] Conditions other than antimicrobial administration could predispose to C difficile pseudomembranous colitis. Such conditions include bowel ischemia, recent bowel surgery, uremia, dietary change, change in bowel motility, malnutrition, chemotherapy, shock, and Hirschsprung disease.

• #20 Non-clostridium difficile induced pseudomembranous colitis

  https://www.wjgnet.com/2307-8960/full/v11/i5/979.htm

  Pseudomembranes are composed of mucus, fibrinous material, inflammatory cells (neutrophils), and cellular debris over the colonic mucosa with mucosal damage of varying degrees. […] Other than Clostridium difficile other bacterial infections, Viral, parasitic and fungal infections have been implicated in antibiotic-associated colitis. […] The prior literature describes antibiotic-associated hemorrhagic and non-hemorrhagic colitis from Methicillin-resistant staphylococcus aureus. […] In a systematic review by Motamedi et al Klebsiella, oxytoca was the most common cause of antibiotic-associated diarrhea in hospitalized patients, with a prevalence of 27%. […] Multiple cases of pseudomembranous colitis from CMV have been described in the literature. […] Timerbulatov et al described 19 cases of pseudomembranous colitis that occurred after coronavirus disease 2019 (COVID-19) infection.

• #21 Case of Pseudomembranous Colitis Caused by a Clostridioides difficile Infection Concomitant with Cytomegalovirus colitis Mimicking Ischemic Colitis

  https://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2022.134

  A Clostridioides difficile infection (CDI) is one of the major nosocomial diarrheal diseases. Pseudomembranous colitis (PMC) is a characteristic endoscopic finding of CDI, manifested by white or yellowish plaque covering the colonic mucosa. […] Clostridioides difficile (C. difficile) infection (CDI) is a common nosocomial diarrhea induced by disruption of intestinal microbiota. Pseudomembranous colitis (PMC) is a characteristic endoscopic finding of CDI, manifested by white or yellowish plaques on the colonic mucosa. Ischemic colitis is inflammation of the colon manifested by mucosal denudation and friability. Ischemic colitis is rarely associated with CDI. […] This paper describes a case of CDI concomitant with CMV colitis, manifested by PMC and ischemic colitis. CDI likely caused the PMC, and the CMV infection caused the ischemic colitis. The patient was cured using an anti-CDI treatment and ganciclovir.

• #22 Pseudomembranous Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4402243/

  Ischemia as a cause of PMC is not a novel concept, but it is often not recognized early in the course of disease, owing to the strong association of pseudomembranes with CDI. […] Pseudomembranes can develop very early in the course of CDI with only mild symptoms. […] Pseudomembranes may be absent or too small for visualization by endoscopy. […] Pseudomembranes were identified in 52.7% of abnormal biopsy samples, and were composed of neutrophils, inflammatory debris, fibrin, and sloughed epithelial cells. […] Pseudomembranous colitis has been reported in a case of ulcerative colitis exacerbation in association with CMV antigenemia and positive CMV immunohistochemistry in colonic mucosa. […] Medications, drugs, and chemicals can cause PMC by localized ischemia and/or inflammation. […] An isolated case report of paraquat (herbicide) toxicity causing PMC was published in 1981, but it is unclear what testing was pursued to make the diagnosis.

• #23 Pseudomembranous colitis: Not always Clostridium difficile | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/83/5/361

  Awareness of causes of pseudomembranous colitis other than C difficile infection, the focus of this review, is key to prompt diagnosis and potentially life-saving patient care. […] A wide differential diagnosis should be maintained, especially when there are clues that C difficile infection may not be the correct diagnosis. […] Several chemicals and medications can injure the bowel and predispose to pseudomembrane formation. […] C difficile is the organism most commonly linked to pseudomembranous colitis, but other bacterial, viral, and parasitic pathogens have also been implicated. […] Colon ischemia usually affects elderly or debilitated patients who have multiple comorbidities. […] An increasing number of cases of pseudomembranous changes are being reported in patients diagnosed with collagenous colitis. […] Crohn disease and ulcerative colitis have been associated with pseudomembranous colitis. […] Pseudomembranous colitis can occur in Behet disease in the absence of C difficile infection or any infectious colitis.

• #24 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?volume=80&number=2&spage=93

  Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury’s onset, duration, and extent of involvement in colon segments. […] In addition to being caused mostly by a severe Clostridium difficile infection (CDI), pseudomembranous colitis (PMC) is characterized by yellowwhite nodules or plaques and can be a consequence of other disease processes, including severe IC. […] The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure. PMC is distinguished by raised yellow-white nodules or plaque on the mucosal surfaces of the colon that form pseudomembranes. […] In the case of IC, despite being uncommon, PMC is not a novel phenomenon and may be induced by hypoperfusion.

• #25 Pseudomembranous Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4402243/

  Glutaraldehyde is a chemical solution used to disinfect endoscopes after use, and its association with PMC is a well-described phenomenon that occurs after inadequate rinsing of the solution from cleaned endoscopes. […] Pseudomembranous colitis due to Behcets disease was reported in a 5-year-old boy. […] A case of pseudomembranous colitis due to Yersinia enterocolitica has been described. […] Two cases of ischemic necrosis of the sigmoid colon associated with pseudomembranous colitis due to Schistosoma mansoni in children have been reported. […] Two cases of fulminant amebic colitis with pseudomembrane formation have been reported, both of which required colectomy, with one patient dying two weeks after initial diagnosis.

• #26 Pseudomembranous Colitis – MD Searchlight

  https://mdsearchlight.com/infectious-disease/pseudomembranous-colitis/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=27943

  Pseudomembranous colitis is a severe inflammation or irritation of the inner layer of the large intestine, often occurring as a result of taking antibiotics. Its primarily caused by an intense infection from a bacterium named Clostridium difficile. […] Pseudomembranous colitis is usually caused by an infection from a bacterium called C. difficile. But there are other less common causes such as a lack of blood supply to the colon (ischemic colitis), a type of bowel disease that results in inflammation and ulcers (inflammatory bowel disease), an infection related to the herpes virus (cytomegalovirus-induced colitis), blood vessel inflammation (vasculitis), certain bacterial and parasitic infections, a rare disorder that results in inflammation of blood vessels throughout your body (Behcets Disease), certain chemotherapy drugs, and exposure to toxins like heavy metals.

• #27 Pseudomembranous Colitis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/pseudomembranous-colitis

  Disease has been reported following as little as one dose of antibiotic. […] Although the attributable risk has varied among studies, fluoroquinolones, macrolides, clindamycin, beta-lactam/beta-lactamase inhibitors and cephalosporins have been shown to pose a significant risk for the development of CDI. […] Antineoplastic agents and proton pump inhibitors have also been associated with CDI.

• #28 Pseudomembranous colitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudomembranous-colitis/symptoms-causes/syc-20351434

  Certain diseases that affect the colon, such as ulcerative colitis or Crohn’s disease, also may put people at risk of pseudomembranous colitis. […] More and more often, C. difficile is being reported in people with no known risk factors, including people with no recent health care contact or use of antibiotics. This is called community-acquired C. difficile. […] An aggressive strain of C. difficile has emerged that produces far more toxins than other strains do. The new strain may be more resistant to certain medicines and has been reported in people who haven’t been in the hospital or taken antibiotics.

• #29 Non-clostridium difficile induced pseudomembranous colitis

  https://www.wjgnet.com/2307-8960/full/v11/i5/979.htm

  Pseudomembranous colitis can occur in patients with IBD during a flare with or without superimposed causative factors such as infections, medication, and drug usage. […] Pseudomembranous colitis is a pathological finding on endoscopy and is not only due to CDI. Infectious, inflammatory, Drug, and Ischemic causes should be investigated in a patient with endoscopic findings of pseudomembranous colitis and negative CDI on testing or refractory to CDI treatment.

• #30 Pseudomembranous colitis

  https://adamcertificationdemo.adam.com/content.aspx?productid=141&isarticlelink=false&pid=1&gid=000259

  Pseudomembranous colitis is uncommon in children, and rare in infants. It is most often seen in people who are in the hospital. However, it is becoming more common in people who take antibiotics and are not in a hospital. […] Risk factors include: Older age, Antibiotic use, Use of medicines that weaken the immune system (such as chemotherapy medicines), Recent surgery, History of pseudomembranous colitis, History of ulcerative colitis, Crohn disease, and inflammatory bowel disease (IBD). C difficile can happen in IBD patients even without taking antibiotics.

• #31 Pseudomembranous colitis | Lima Memorial Health System

  https://www.limamemorial.org/health-library/HIE%20Multimedia-TextOnly/1/000259

  Risk factors include: Older age, Antibiotic use, Use of medicines that weaken the immune system (such as chemotherapy medicines), Recent surgery, History of pseudomembranous colitis, History of ulcerative colitis, Crohn disease, and inflammatory bowel disease (IBD). C difficile can happen in IBD patients even without taking antibiotics.

• #32 11. Pseudomembranous Colitis Images | PPT

  https://www.slideshare.net/ensteve/11-pseudomembranous-colitis-images

  Most cases of PMC over the last three decades have occurred in association with antimicrobial therapy. Nearly all antimicrobial agents have been implicated in causing PMC. […] Other risk factors advanced age, hospitalization, inflammatory bowel disease, chemotherapy, and immunosuppression. […] Broad spectrum antibiotic usage (such as clindamycin) and/or immunosuppression allows overgrowth of bacteria such as Clostridium difficile. […] Colonization resistance Definition – ability of the normal intestinal microflora to resist overgrowth by pathogenic organisms. […] Toxin production by pathogens toxin A (or enterotoxin) toxin B (or cytotoxin). […] In mild or moderate cases, supportive therapy alone is sufficient. […] Oral treatment with antimicrobial agents effective against C difficile is the preferred treatment.

• #33 Pseudomembranous colitis

  https://ask-ahd.ahdubai.com/con-20157211

  Factors that may increase your risk of pseudomembranous colitis include: Taking antibiotics; Staying in the hospital or a nursing home; Increasing age, especially over 65 years; Having a weakened immune system; Having a colon disease, such as inflammatory bowel disease or colorectal cancer; Undergoing intestinal surgery; Receiving chemotherapy treatment for cancer. […] The natural occurrence of new, more-aggressive strains of C. difficile, which are more resistant to antibiotics, has made treating pseudomembranous colitis increasingly difficult and recurrences more common.

• #34 What Is Pseudomembranous Colitis?

  https://www.icliniq.com/articles/gastro-health/pseudomembranous-colitis

  Pseudomembranous colitis refers to swelling of the large intestine and is the common cause of diarrhea post-antibiotic usage. […] Pseudomembranous colitis also known as antibiotic-associated colitis or Clostridium difficile colitis is a potentially life-threatening acute infectious colitis causing inflammation of the colon due to an overgrowth of the bacterium Clostridium difficile. The overgrowth of the bacteria is often related to a recent hospital stay or antibiotic treatment and is more common among people over 65 years old. […] The Clostridium difficile bacteria is a usual inhabitant of the intestine. However, abnormal growth of the bacteria may take place when antibiotics are taken. A potent toxin produced by the bacteria causes inflammation and bleeding in the lining of the colon.

• #35 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] Ultimately, many of the genetic influences on CDI and the clinical course of C difficile colitis likely remain unknown.

• #36 Pseudomembranous Colitis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/pseudomembranous-colitis/

  Pseudomembranous colitis is inflammation of the colon caused by an overgrowth of the bacterium Clostridioides difficile. This condition is associated with antibiotic use and the consequent disruption of the normal colonic microbiota. […] Caused by toxigenic strains of C. difficile: Gram-positive bacillus. […] Recent antibiotic treatment is the main risk factor. Most commonly implicated antibiotics: Clindamycin, Cephalosporins, Fluoroquinolones, Ampicillin. […] Other risk factors: Proton-pump inhibitors, Advanced age 65, Medical comorbidities, Hospitalization, Gastrointestinal surgery, Enteral feeding, Obesity, Chemotherapy, Hematopoietic stem cell transplantation, Inflammatory bowel disease, Cirrhosis. […] Disruption of the normal flora using antibiotics leads to the overgrowth of C. difficile. […] Intestinal damage is due to toxin release. […] Causes pseudomembranous colitis.

• #37 Pseudomembranous Colitis Causes And Symptoms – Klarity Health Library

  https://my.klarity.health/pseudomembranous-colitis-causes-and-symptoms/

  Pseudomembranous (Soo-dough-mem-bruh-nus) colitis (PMC) is an inflammatory condition of the colon, or large intestine, which is an organ of the digestive system. PMC often manifests as severe inflammation of the colon due to excessive usage of antibiotics or a bacterial infection caused by Clostridioides difficile (C. difficile). […] Clostridioides difficile (C. difficile), formerly Clostridium difficile, is a bacterial infection most commonly known to affect individuals who take certain antibiotics. It causes infectious diarrhoea and pseudomembranous colitis and is highly prevalent amongst hospitalised patients of the elderly population or those with weakened immune systems. […] The risk factors for C. difficile infection (CDI) include the following: Increased age: individuals aged over 65 years old are more susceptible to developing a C. difficile infection; Antibiotic treatment: disruption of the gut flora due to intake of antibiotics allowing for the growth of C. difficile and can cause antibiotic-associated diarrhoea; Prolonged hospitalisation: individuals who remain in the hospital setting for an extended period of time are at high risk of developing CDI; Immunosuppressive therapy: individuals undergoing certain medical treatments such as chemotherapy are at risk of developing CDI because the treatment has the ability to suppress the body’s natural ability to defend against C. difficile.

• #38 Clostridial colitis: causes, symptoms, diagnosis and treatment in Moscow

  https://www.k31.ru/en/service/gastroenterologiya/clostridial-colitis.html

  In addition to antibiotic treatment, there are other factors that can increase the risk of developing clostridial colitis. […] Sometimes the disease develops in patients with chronic obstructive pulmonary disease. Also a provoking factor is the use of H2-histamine receptor blockers and proton pump inhibitors.

• #39 What Is Pseudomembranous Colitis?

  https://www.icliniq.com/articles/gastro-health/pseudomembranous-colitis

  Any antibiotic can cause pseudomembranous colitis. However, some antibiotics are more often associated with pseudomembranous colitis than others. […] Other medications, such as chemotherapy drugs used to treat cancer, can sometimes cause pseudomembranous colitis by disrupting the normal balance of bacteria in the colon. […] Recently, Clostridium difficile has been increasingly reported in people with no known risk factors, including those with no recent history of healthcare contact or use of antibiotics. This is referred to as community-acquired Clostridium difficile. […] Pseudomembranous colitis is primarily caused by the overgrowth of Clostridioides difficile (C. difficile) bacteria in the colon, typically following the use of broad-spectrum antibiotics that disrupt normal gut flora. […] Pseudomembranous colitis is caused by one or more toxins produced by an unopposed proliferation of Clostridium difficile bacteria in acute infectious colitis and usually occurs as a complication of antibiotic therapy.

• #40 Pseudomembranous colitis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20157211/

  C. difficile spores are resistant to many common disinfectants and can be transmitted from the hands of health care professionals to patients. More and more often, C. difficile is being reported in people with no known risk factors, including people with no recent health care contact or use of antibiotics. This is called community-acquired C. difficile. […] An aggressive strain of C. difficile has emerged that produces far more toxins than other strains do. The new strain may be more resistant to certain medicines and has been reported in people who haven’t been in the hospital or taken antibiotics.

• #41 Pseudomembranous colitis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/pseudomembranous-colitis

  Other medicines besides antibiotics can sometimes cause pseudomembranous colitis. Chemotherapy drugs that are used to treat cancer may disrupt the normal balance of bacteria in the colon. […] Certain diseases that affect the colon, such as ulcerative colitis or Crohn’s disease, also may put people at risk of pseudomembranous colitis. […] More and more often, C. difficile is being reported in people with no known risk factors, including people with no recent health care contact or use of antibiotics. This is called community-acquired C. difficile. […] An aggressive strain of C. difficile has emerged that produces far more toxins than other strains do. The new strain may be more resistant to certain medicines and has been reported in people who haven’t been in the hospital or taken antibiotics.

• #42 C. Diff, Pseudomembranous Colitis, and IBD: What To Know | MyCrohnsAndColitisTeam

  https://www.mycrohnsandcolitisteam.com/resources/c-diff-pseudomembranous-colitis-and-ibd-what-to-know

  C. diff is a type of bacteria that affects the intestines and can cause life-threatening colitis (inflammation of the colon). […] Researchers have attributed a newer strain of the bacteria to an increase in incidence and severity of C. difficile infections (CDIs) over the past decade. […] People living with IBD have a five times higher incidence of C. diff infection than the rest of the population. These higher rates are because people with IBDs take immunosuppressant drugs, have antibiotic therapy, and spend a lot of time in hospitals. […] Since broad-spectrum antibiotic use became common, C. diff has been the leading cause of pseudomembranous colitis, causing 90 percent of cases.

• #43 Pseudomembranous Colitis Causes And Symptoms – Klarity Health Library

  https://my.klarity.health/pseudomembranous-colitis-causes-and-symptoms/

  Besides antibiotic usage, there are several other ways a person can develop pseudomembranous colitis, mainly through colon disorders such as inflammatory bowel disease and Behcets disease, amongst others. […] Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal (GI) tract that encompasses ulcerative colitis and Crohns disease. IBD patients are given antibiotics and treatments that alter the composition of the intestine, favouring overgrowth of C. difficile and causing inflammation that damages the colon lining and allows for the formation of pseudomembranes. […] The most common risk factor associated with pseudomembranous colitis is C. difficile infection, which as mentioned earlier has a significant side effect of potentially causing diarrhoea.

• #44 Pseudomembranous enterocolitis – wikidoc

  https://www.wikidoc.org/index.php/Pseudomembranous_enterocolitis

  The use of systemic antibiotics, including (but not limited to) any penicillin-based antibiotic such as amoxicillin, cephalosporins, and clindamycin, causes the normal bacterial flora of the bowel to be altered. In particular, when the antibiotic kills off other competing bacteria in the intestine, any bacteria remaining will have less competition for space and nutrients. The net effect is to permit more extensive growth than normal of certain bacteria. Clostridium difficile is one such type of bacterium. In addition to proliferating in the bowel, C. difficile also produces toxins. Without either toxin A or toxin B, C. difficile may colonize the gut, but is unlikely to cause pseudomembranous colitis. […] Other risk factors include increasing age and recent major surgery. Some evidence shows proton pump inhibitors are a risk factor for C. difficile infection and pseudomembranous colitis, but others question whether this is a false association or statistical artifact.

• #45 C. Diff Infection: Symptoms, Causes, Diagnosis and Treatment

  https://www.webmd.com/digestive-disorders/clostridioides-difficile-colitis

  Clostridioides Difficile Causes […] C. diff exists all around us. It’s in the air, water, soil, and the feces of humans and animals. […] Clostridium difficile (C. diff) is a highly contagious bacterial infection of the colon. It’s typically caused by taking certain antibiotics, which can interfere with the balance between good and bad bacteria in your gut. […] C. diff bacteria that are outside the body turn into spores that can live on surfaces for weeks or months. These spores are not „active,” but they can turn active after you swallow them and they get into your intestines. Some people have the bacteria in their intestines and never have any symptoms. But for others, the bacteria make toxins that attack the intestines. […] A new strain of C. diff bacteria makes larger amounts of toxins. These types are hard to treat with medications.

• #46 Clostridioides difficile colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/clostridioides-difficile-colitis?lang=us

  Clostridioides difficile colitis, also known as pseudomembranous colitis and previously known as Clostridium difficile colitis, is a common cause of antibiotic-associated diarrhea, and increasingly encountered in sick hospitalized patients. If undiagnosed and untreated, it continues to have high mortality. It may be classified as a form of infectious colitis. […] C. difficile infection is usually preceded by antibiotic use or chemotherapy and is therefore usually encountered in unwell, hospitalized patients with significant comorbidity. […] Clostridioides difficile (formerly Clostridium difficile) is a Gram-positive anaerobic bacterium that does not normally inhabit the bowel but can colonize it following disruption of normal colonic flora, commonly due to antibiotic use or chemotherapy within six weeks of onset. […] A pseudomembrane on the colonic mucosa, consisting of fibrin, white cells, and cellular debris, is characteristic of the condition. […] Untreated pseudomembranous colitis carries a high mortality from the sequelae of toxic megacolon and perforation.

• #47 Pseudomembranous Colitis – The Gastrointestinalatlas – gastrointestinalatlas.com

  https://www.gastrointestinalatlas.com/english/pseudomembranous_colitis.html

  Development of pseudomembranes in the gastrointestinal tract during acute inflammatory or vascular diseases has been confined to the small and/or large bowel, with rare occurrences in the esophagus. Pseudomembranous enterocolitis is a serious, often fatal disease that usually follows antimicrobial therapy and Clostridium difficile infection. […] Therapy for PMC includes discontinuation of implicated antimicrobial agents, administration of antimicrobial agents directed against C. difficile, and supportive measures. […] Clostridium difficile infection (CDI) is a frequent cause of morbidity and mortality among elderly hospitalized patients. […] Both the incidence and severity of CDI are increasing. Fulminant CDI is underappreciated as a life-threatening disease because of a lack of awareness of its severity and its nonspecific clinical syndrome. Early diagnosis and treatment are essential for a good outcome, and early surgical intervention should be used in patients who are unresponsive to medical therapy.

• #48

  https://journals.lww.com/10.14309/01.ajg.0001041412.40346.ce

  Pseudomembranous Colitis (PMC) is a severe inflammation of the inner lining of the large intestine. It most commonly presents as a complication from a severe Clostridioides difficile (C diff) infection, however, there are several less common causes such as ischemic colitis, collagenous colitis, inflammatory bowel disease, cytomegalovirus-induced colitis, vasculitis, bacterial and parasitic organisms, Behcets Disease, chemotherapeutic medications, and toxins such as heavy metal poisoning. […] About 3%-8% of pseudomembranous colitis will develop fulminant infection including severe ileus, toxic megacolon, hypovolemia, hypotension, renal dysfunction, colonic perforation with peritonitis, and septic shock. […] Given its relatively low mortality and morbidity rate, this leads to the question of whether PMC not associated with C diff leads to clinically worse outcomes. […] Patients who have been identified with pseudomembranous colitis using colonoscopy and additionally failing C diff treatment warrant a wider etiology investigation and tailoring of medical management. […] Table 1. – Treatment for various causes of Pseudomembranous colitis per prior literature.

• #49 11. Pseudomembranous Colitis Images | PPT

  https://www.slideshare.net/ensteve/11-pseudomembranous-colitis-images

  In severe cases, in cases where supportive therapy fails, and in cases where the offending antibiotic cannot be discontinued, a short course (7-10 d) of specific antibiotic therapy should be administered along with the supportive therapy. […] Surgical Therapy Two thirds of patients with toxic megacolon require surgical intervention. […] Many patients remain asymptomatic carriers for C difficile, and most of them never relapse. […] The overall mortality rate is 2%. The mortality rate in untreated elderly or debilitated patients is 10-20%. Even with surgical intervention, the mortality rate in patients with toxic megacolon is 35%.

• #50 A Case Report of Pseudomembranous Colitis Resulting from Clostridium difficile Infection Successfully Treated with Fidaxomicin | Cardoso | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/2632/1988

  Pseudomembranous colitis (PMC) is a serious condition caused by Clostridium difficile, often arising after antibiotic therapy in the healthcare setting. […] C. difficile is the main agent for PMC. […] The main risk factor for the development of CDI is exposure to antibacterial therapy, classically broad-spectrum agents, which are able to disrupt colonic microflora. […] The clinical presentation of CDI is caused by toxins A and B, produced by C. difficile, responsible for inflammation, damage the lining of the colon and cause inflammation leading to diarrhea and colitis. […] According to the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines, recurrence is the major challenge in the treatment of CDI, with up to 25% of patients with CDI suffering a recurrence of infection within 30 days after treatment with metronidazole or vancomycin and 45-65% of these patients present subsequent recurrences.

• #51 A Case Report of Pseudomembranous Colitis Resulting from Clostridium difficile Infection Successfully Treated with Fidaxomicin | Cardoso | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/2632/1988

  New drugs have emerged for the treatment of CDI, including fidaxomicin, a macrocyclic antibiotic, the first in its class. […] Fidaxomicin has a narrow spectrum of action, with minimal impact on anaerobic natural commensal colonic microflora. […] Fidaxomicin inhibits spore formation and toxin production by C. difficile. […] Fidaxomicin was non-inferior to vancomycin for initial cure of CDI, but significantly reduced the rate of disease recurrence, contributing to an increase in sustained clinical cure. […] Our patient was considered to be at high risk of PMC recurrence and indeed suffered a recurrence soon after completing first-line treatment with vancomycin. […] Therefore, fidaxomicin may be an appropriate alternative therapy in cases of recurrence, and may be appropriate even during the first episode of CDI in patient at high risk of recurrence.

• #52 Pseudomembranous colitis: Not always Clostridium difficile | MDedge

  https://medauth2.mdedge.com/content/pseudomembranous-colitis-not-always-clostridium-difficile

  When pseudomembranous colitis is confirmed endoscopically, C difficile infection naturally comes to mind, but the two terms are not interchangeable. A wide differential diagnosis should be maintained, especially when there are clues that C difficile infection may not be the correct diagnosis. […] Several chemicals and medications can injure the bowel and predispose to pseudomembrane formation. […] C difficile is the organism most commonly linked to pseudomembranous colitis, but other bacterial, viral, and parasitic pathogens have also been implicated. […] Colon ischemia usually affects elderly or debilitated patients who have multiple comorbidities. […] An increasing number of cases of pseudomembranous changes are being reported in patients diagnosed with collagenous colitis. […] Crohn disease and ulcerative colitis have been associated with pseudomembranous colitis. Pseudomembranes can be found on endoscopy in patients with inflammatory bowel disease during a disease exacerbation with or without C difficile. […] Pseudomembranous colitis can occur in Behet disease in the absence of C difficile infection or any infectious colitis.

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