Salmonella infection can cause an asymptomatic intestinal carrier state or clinical diseases such as enterocolitis presenting abdominal pain, fever, vomiting, or diarrhea. Salmonella usually invades Peyer's patch of terminal ileum or ascending colon. Sepsis is not common and acute renal failure secondary to rhabdomyolysis is rare. The causes of rhabdomyolysis are trauma, excessive exercise, alcohol, seizure, metabolic abnormality, and infection. Infections account for less than 5% of the reported causes of rhabdomyolysis and resulting acute renal failure. The mechanisms underlying rhabdomyolysis due to infection are direct muscle invasion, toxin production, and nonspecific effects that can occur with infections such as fever, dehydration, acidosis, and electrolyte imbalance. We report a case of sepsis and acute renal failure secondary to rhabdomyolysis associated with Salmonella infection.
Colonoscopy ; Enterocolitis/complications/*diagnosis ; Humans ; Kidney Failure, Acute/*diagnosis/etiology ; Male ; Middle Aged ; Rhabdomyolysis/diagnosis/etiology/microbiology ; Salmonella Infections/complications/*diagnosis ; Sepsis/*diagnosis/etiology ; Tomography, X-Ray Computed

Methicillin resistant Staphylococcal aureus (MRSA) enterocolitis is characterized by high fever, abdominal distension, and watery diarrhea that leads to severe dehydration, shock, a sharp decrease in the white cell counts and sometimes multiple organ failure. Clinically, it can be an another cause of nosocomial diarrhea. If MRSA enteritis is suspected from the clinical symptoms, prompt treatment and strict prophylactic measures including vancomycin, are most important for its management. We recently observed a case of MRSA enterocolitis as a nosocomial infection in a patient with acute pancreatitis. This patient showed uncontrolled massive diarrhea, fever, and multiple organ failure. We report a case of MRSA enterocolitis with a review of literatures.
Cross Infection/diagnosis/*microbiology ; Diarrhea/etiology/*microbiology ; Enterocolitis/complications/diagnosis/*microbiology ; Humans ; Male ; *Methicillin Resistance ; Middle Aged ; *Staphylococcal Infections/diagnosis

Antibiotics-associated diarrhea (AAD) is defined as unexplained diarrhea that occurs with the administration of antibiotics. Approximately 20% AAD cases are due to Clostridium difficile. Over the last decade, the incidence of Clostridium difficile-associated disease (CDAD) has progressively increased, and now a significant clinical problem. Recent change in the epidemiology of CDAD and the emergence of an epidemic hypervilruent strain suggest the need for greater attention for infection control, early diagnosis, and more effective treatment modality. However, since most cases of CDAD are both iatrogenic and nosocomial, careful selection of antibiotics, combined with proper hand hygiene and precaution by medical staffs are required.
Anti-Bacterial Agents/*adverse effects/therapeutic use ; *Clostridium difficile ; Diarrhea/*etiology ; Enterocolitis, Pseudomembranous/diagnosis/*etiology/therapy ; Humans ; Immunotherapy ; Recurrence

This study was performed to identify clinical factors that facilitate the diagnosis of typical cow's milk protein-induced enterocolitis (CMPIE). Data from 142 consecutive patients (aged 15 to 45 days, cow's milk formula- or cow's milk and breast milk mixed-fed) admitted due to vomiting and/or diarrhea were retrospectively analyzed. These 142 subjects were divided into three groups: the CMPIE, infection, and non-infection group. Each group was composed of 16 (11.3%), 102 (71.8%), and 24 (16.9%) patients, respectively. On admission, poor weight gain (p=0.003), hypoalbuminemia (p=0.035), peripheral leukocytosis (p=0.012), and metabolic acidosis (p=0.015) were found to be more significant in the CMPIE group than those in other two groups. In CMPIE, serum albumin levels decreased from 3.3+/-0.9 g/dL on admission to 2.6+/-0.3 g/dL during admission (p<0.05), and methemoglobinemia was observed in 3 patients (18.8%) (p=0.012). Multiple logistic regression analysis showed that the independent predictors of CMPIE versus the infection group were failure to gain weight (OR, 10.75 [95% CI, 1.53-66.12]) (p= 0.014) and hypoalbuminemia (OR, 9.53 [95% CI, 1.62-49.01]) (p=0.010). The early recognition of indexes of suspicion for CMPIE may be of help in the diagnosis and treatment of this disorder.
Acidosis/etiology ; Animals ; Cattle ; Enterocolitis/*diagnosis/etiology ; Female ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Logistic Models ; Male ; Methemoglobinemia/etiology ; Milk Hypersensitivity/*diagnosis ; Milk Proteins/*immunology ; Serum Albumin/analysis ; Weight Gain

Animals ; Anti-Bacterial Agents ; administration & dosage ; Enterocolitis, Necrotizing ; diagnosis ; etiology ; prevention & control ; Humans ; Immunoglobulins ; therapeutic use ; Infant, Newborn ; Prebiotics ; Probiotics ; therapeutic use

Pseudomembranous colitis (PMC) is known to be associated with the administration of antibiotics which alter normal gastrointestinal flora and allow overgrowth of Clostridium difficile. Most cases of rifampicin-induced PMC are seen in patients with pulmonary tuberculosis, but not with gastrointestinal tuberculosis. We report a case of PMC associated with rifampicin therapy in a patient with gastrointestinal tuberculosis. A 65-year-old female patient with rectal cancer and gastrointestinal tuberculosis was admitted due to abdominal pain and diarrhea. She was treated with anti-tuberculosis agents containing rifampicin. On colonoscopic examination, mucoid exudates and yellowish plaque lesions were observed. Anti-tuberculosis agents were stopped, and the patient was treated with metronidazole. Symptoms were relieved and did not recur when all the anti-tuberculosis agents except rifampicin were started again. When a patient complains of abdominal pain or diarrhea while taking rifampicin, the physician should consider the possibility of rifampicin-associated PMC.
Aged ; Antibiotics, Antitubercular/*adverse effects/therapeutic use ; Enterocolitis, Pseudomembranous/*diagnosis/etiology/pathology ; Female ; Humans ; Rectal Neoplasms/*complications/diagnosis ; Rifampin/*adverse effects/therapeutic use ; Sigmoidoscopy ; Tuberculosis, Gastrointestinal/complications/diagnosis/*drug therapy

This study was performed to investigate the significance of gastric juice analysis (GJA) as a diagnostic criterion of a positive challenge in a standard oral cow's milk challenge (OCC) to confirm typical cow's milk protein-induced enterocolitis (CMPIE). Data from 16 CMPIE patients (aged 14 to 44 days) were analyzed. A standard OCC was openly executed using 0.15 g/kg of protein. Three symptoms (vomiting, lethargy, and bloody or pus-like stool), and four laboratory findings (GJA [3 hr], changes in peripheral blood absolute neutrophil count [ANC] [6 hr], C-reactive protein [6 hr], and stool smear test for occult blood or leukocytes) were observed after OCC. Before OCC, baseline studies were conducted; a stool smear test, blood sampling, and GJA. Positive OCC results were; vomiting (87.5%) (observed 1-3 hr after OCC), lethargy (62.5%) (1-3 hr), bloody or pus-like stool (43.8%) (6-10 hr), abnormal GJA (93.8%), an ANC rise >3,500 cells/microliter (93.8%), and an abnormal stool smear test (75.0%). A single GJA test after a standard OCC is a sensitive diagnostic criterion of a positive challenge, and may provide an early confirmatory diagnosis of CMPIE. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in CMPIE.
Adolescent ; Adult ; Algorithms ; Animals ; Blood Cell Count ; C-Reactive Protein/analysis ; Cattle ; Enterocolitis/*diagnosis/*etiology ; Female ; *Gastric Juice ; Humans ; Male ; Milk Hypersensitivity/*diagnosis/*pathology ; Milk Proteins/*analysis ; Neutrophils/cytology

No abstract availble
Antimetabolites, Antineoplastic/*adverse effects/therapeutic use ; Colon/pathology/radiography ; Colonoscopy ; Enterocolitis, Pseudomembranous/diagnosis/*etiology ; Fluorouracil/*adverse effects/therapeutic use ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/*drug therapy ; Tomography, X-Ray Computed

Pseudomembranous colitis is mainly caused by antibiotics and Clostridium difficile infection. But conditions such as gastrointestinal surgery, antacid medication, anti-neoplastic agent or immunosuppressive agent which influences the normal flora of colon can induce colitis without the administration of any antibiotics. We experienced a 13 year-old male who was taking low-dose methotrexate for juvenile rheumatoid arthritis complained diarrhea and abdominal pain for 3 weeks. Sigmoidoscopic findings revealed diffuse patch yellowish pseudomembranes on the rectum. Histologic finding was compatible to pseudomembranous colitis. His symptom was improved after stop taking methotrexate and the administration of metronidazole. If a patient treated with immunosuppressive agents or antineoplastic agents complains diarrhea, fever or abdominal pain and has not improved with conservative care, pseudomembranous colitis should be taken into account as a differential diagnosis and prompt treatment is required for better prognosis.
Abdominal Pain/etiology ; Adolescent ; Anti-Infective Agents/therapeutic use ; Antirheumatic Agents/*adverse effects/therapeutic use ; Arthritis, Juvenile Rheumatoid/*drug therapy ; Diagnosis, Differential ; Diarrhea/etiology ; Enterocolitis, Pseudomembranous/*diagnosis/drug therapy/pathology ; Humans ; Male ; Methotrexate/*adverse effects/therapeutic use ; Metronidazole/therapeutic use ; Sigmoidoscopy ; Tomography, X-Ray Computed

Anti-Bacterial Agents ; therapeutic use ; Emergencies ; Enterocolitis, Necrotizing ; diagnosis ; epidemiology ; etiology ; prevention & control ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; epidemiology ; etiology ; prevention & control ; Infant, Very Low Birth Weight ; Infection Control ; Intensive Care Units, Neonatal ; Premature Birth ; prevention & control ; Risk Factors