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Difficulties in diagnosing antibiotic-associated diarrhea using a clinical case example

Difficulties in diagnosing antibiotic-associated diarrhea using a clinical case example

Abstract

Мета роботи – визначення складності діагностики та лікування хворих з ураженням кишечника внаслідок тривалого приймання антибіотиків. Матеріали та методи. Описали та проаналізували випадок антибіотик-асоційованої діареї у хворої віком 65 років. Результати. У хворої з поєднаною патологією шлунково-кишкового тракту та перенесеним раком сигмовидної кишки після операції з видалення селезінки виникло ускладнення – антибіотик-асоційована діарея. Клінічна картина діареї ускладнилася розвитком псевдомембранозного коліту, що маскувалася лейкемоїдною реакцією та септичним процесом. У пацієнтки перебіг захворювання мав рецидивний характер, виникла поліорганна недостатність, яка і спричинила летальний наслідок. Висновки. Антибіотик-асоційована діарея, спричинена Clostridia difficile, зумовила виникнення в пацієнтки псевдомембранозного коліту. Складність діагностики полягала в тому, що у хворої клінічні ознаки мали маску звичайної кишкової інфекції, септичного процесу та лейкемоїдної реакції.

Aim. To identify challenges in the diagnosis and treatment of a patient with intestinal damage due to long-term use of antibiotics. Material and methods. The case of antibiotic-associated diarrhea in a 65-year-old patient is described and analyzed. Results. The patient with a combined pathology of the gastrointestinal tract and cancer of the sigmoid colon developed a complication after a splenectomy – antibiotic-associated diarrhea. The clinical picture of diarrhea was complicated by the development of pseudomembranous colitis, which was masked by a leukemoid reaction and a septic process. The patient with the relapsing disease course developed multiple organ failure that resulted in a lethal outcome. Conclusions. Diarrhea associated with Clostridia difficile caused the development of pseudomembranous colitis. At the same time, the clinical picture of the disease had a mask of a leukemoid reaction and a septic process.

Keywords

treatment, псевдомембранозний коліт, diagnosis, лікування, антибіотик-асоційована діарея, diarrhea, pseudomembranous colitis, діагностика

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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