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Clostridium difficile diarrhea : ウィキペディア英語版
Clostridium difficile colitis


''Clostridium difficile'' colitis or pseudomembranous colitis is colitis (inflammation of the large intestine) resulting from infection with ''Clostridium difficile'', a spore-forming bacterium. It causes an infectious diarrhea called ''C. difficile'' associated diarrhea (CDAD). Latent symptoms of ''Clostridium difficile'' infection (CDI) often mimic some flu-like symptoms and may mimic disease flare-ups in people with inflammatory bowel disease–associated colitis. ''C. difficile'' releases toxins that may cause bloating and diarrhea, with abdominal pain, which may become severe.

The colitis is thought to occur when this bacterium replaces normal gut flora that has been compromised, usually following antibiotic treatment for an unrelated infection. The disturbance of normal healthy bacteria may provide ''C. difficile'' an opportunity to overrun the intestinal microbiome. It is a type of antibiotic-associated diarrhea.

Often, mild cases of CDI may be treated by discontinuing the offending antibiotics. More serious cases require targeted antibiotic treatment. Relapses of CDI have been reported in up to 20% of cases. ''C. difficile'' infection is a growing problem in health care facilities, killing approximately 29,000 people in the United States in 2011.〔
== Signs and symptoms ==
Signs and symptoms range from mild diarrhea to severe life-threatening inflammation of the colon.〔Joshi NM, Macken L, Rampton D (2012). "Inpatient diarrhoea and ''Clostridium difficile ''infection". ''Clinical Medicine''. 12 (6): 583-588.〕
In adults, a clinical prediction rule found the best signs to be significant diarrhea ("new onset of more than three partially formed or watery stools per 24-hour period"), recent antibiotic exposure, abdominal pain, fever (up to 40.5 °C or 105 °F), and a distinctive foul odor to the stool resembling horse manure. In a population of hospitalized patients, prior antibiotic treatment plus diarrhea or abdominal pain had a sensitivity of 86% and a specificity of 45%. In this study with a prevalence of positive cytotoxin assays of 14%, the positive predictive value was 18% and the negative predictive value was 94%.
In children, the most prevalent symptom of a CDI is watery diarrhea with at least three bowel movements a day for two or more days, which may be accompanied by fever, loss of appetite, nausea, and/or abdominal pain.〔 Those with a severe infection also may develop serious inflammation of the colon and have little or no diarrhea.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
ウィキペディアで「Clostridium difficile colitis」の詳細全文を読む



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