Infectious Colitis
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Infectious Colitis
Benign Disease- A 57-year-old woman is admitted to the intensive care unit with abdominal distention, diarrhea, and hypotension. Evaluation is significant for white blood cell count of 38,000/mL, lactate of 2.5 mmol/L, and stool cultures positive for Clostridium difficile (C. diff) infection. Computed tomography shows diffuse thickening of the ascending and transverse colon. What is the best surgical intervention?
- A 55-year-old otherwise healthy woman presents with tachycardia, abdominal pain, and diarrhea after taking antibiotics. Computed tomography (CT) shows pancolitis. Infectious workup is positive for Clostridioides difficile (C. diff). She has never had C. diff colitis. What is the initial therapy recommended for her?
- A 75-year-old woman presents with abdominal pain and multiple episodes of diarrhea starting 24 hours prior to presentation. She has had two episodes of Clostridium difficile (C. diff) infection (CDI) in the past 3 months. Stool studies show positive C. diff toxin enzyme immunoassay. Which of the following is the best next step in the treatment of this patient?
- A 30-year-old woman presents with a 6-month history of nonbloody diarrhea. She denies any travel or change in dietary habits. An infectious workup has been negative. What is the best next step?
- A 62-year-old woman presents with profound watery diarrhea. She denies a history of recent antibiotic use. She has no personal history of inflammatory bowel disease (IBD). Stool cultures are negative. The colonoscopy is grossly normal. Biopsies are taken. Of the following, which suggests she has collagenous colitis?
Perioperative- Ulcerative Colitis: Surgical Management
- General Postoperative Complications
- IBD Diagnosis and Evaluation
- Benign Disease
- A 56-year-old woman with a history of recurrent urinary tract infections presents to the emergency department with tachycardia (heart rate 124 beats/min), hypotension (blood pressure 85/38 mm Hg), diffuse abdominal pain, and frequent watery diarrhea following a course of oral antibiotics. Her abdomen is distended and diffusely tender. Her white blood cell count is 25,000/L (25109/L) and her hemoglobin is 15.0 g/dL (150 g/L). The patient is positive for Clostridioides difficile and is not responding to treatment with 125 mg of oral vancomycin. What is the next best option for this patient?
- A 35-year-old woman presents to the emergency department with a history of profuse watery diarrhea, crampy abdominal pain, and vomiting several days after eating oysters. Her laboratory findings are normal except for a mildly elevated white blood cell count, sodium 129 mEq/L (129 mmol/L), chloride 85 mEq/L (85 mmol/L), and potassium 3.2 mEq/L. Stool cultures are positive. Which pathogen is likely associated with this presentation?
- A 76-year-old woman presents with a history of CHF to the hospital with abdominal pain of 24 hours’ duration and bloody diarrhea. Her temperature is 98.6°F (37.0°C), heart rate 90 beats/min, white blood cell count 16,000/mL (16´109/L), and blood pressure 110/70 mm Hg. Computed tomography imaging is ordered (Figure); Her abdomen is tender but without peritoneal signs. Colonoscopy shows patchy, superficial areas of ulceration and sloughing in the transverse colon. The best next treatment for this patient is which of the following?
- A 23-year-old man with a history of ulcerative colitis is admitted to the hospital with bloody diarrhea. His white blood cell count is 13,000/L (13109/L) and hemoglobin is 8.3 g/dL (83 g/L). He is hemodynamically stable. After hospital admission and initiation of intravenous (IV) steroids and infliximab, he undergoes flexible sigmoidoscopy with biopsy. He continues to have 10 to 12 bloody bowel movements daily. Endoscopic and pathologic findings are shown (Figures 1 and 2). What is the best next step in management?
- About ASCRS Textbook of Colon and Rectal Surgery
- Medical Management of Ulcerative Colitis
- Preoperative Evaluation in Colorectal Patients
- Lower Gastrointestinal Hemorrhage
- Radiation, Microscopic, and Ischemic Colitis
- Anorectal Disease
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- Anorectal Disease
- Perioperative
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- Clostridium difficile Infection
- Use of Bowel Preparation in Elective Colon and Rectal Surgery (2019)
- Enhanced Recovery After Colon and Rectal Surgery from ASCRS and SAGES (2023)
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- Crohn’s Disease: Surgical Management
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