Lefika Bathobakae, Rammy Bashir, Atang Koodirile, Katrina Villegas, Islam Rajab, Edgar W Perez, Yana Cavanagh, Abraham El-Sedfy, Jin S Suh
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引用次数: 0
摘要
艰难梭菌肠炎(CDE)是一种罕见但临床意义重大的艰难梭菌感染(CDI)影响小肠。CDE由于其罕见性、复杂性和非特异性表现而对诊断提出了挑战。目前的数据是回顾性的,以病例报告和会议记录的形式。缺乏对CDE的广泛认识和有限的文献常常导致诊断延误,导致发病率增加。这篇有针对性的叙述性综述旨在巩固当前关于CDE的流行病学、病理生理学、临床表现和管理方面的知识,解决现有文献中的一个关键空白。电子数据库,包括PubMed, Embase和Web of Science,检索了从成立到2024年4月发表的病例。最初的搜索产生了2120篇文章,这些文章通过研究设计、英语语言和人类受试者进行了过滤。在筛选重复文献并排除不相关文献后,最终纳入44篇文献,包括49名患者。在49例病例中,男性25例(51%),女性24例(49%)。患者年龄16 ~ 91岁,平均53.4岁。腹痛和腹泻分别为37/49(76%)和35/49(71%)病例的主诉。约42/49例(86%)抗生素治疗有效,部分病例需进行粪便菌群移植或手术探查。鉴于其严重的病程,CDE需要及时和适当的治疗,以防止并发症,如暴发性肠炎、筋膜室综合征和肠穿孔。
Clostridioides difficile enteritis: a targeted review of current literature.
Clostridioides difficile enteritis (CDE) is a rare but clinically significant form of Clostridioides difficile infection (CDI) affecting the small intestine. CDE poses a diagnostic challenge owing to its rarity, complexity, and nonspecific presentation. The current data is retrospective in the form of case reports and conference proceedings. The lack of widespread awareness and limited literature on CDE often result in diagnostic delays, contributing to increased morbidity. This targeted narrative review sought to consolidate the current knowledge on the epidemiology, pathophysiology, clinical presentation, and management of CDE, addressing a critical gap in the existing literature. Electronic databases, including PubMed, Embase, and Web of Science, were searched for published cases from inception to April 2024. The initial search yielded 2,120 articles, which were filtered using study design, English language, and human subjects. After screening for duplicates and excluding irrelevant articles, 44 articles comprising 49 patients were included in the final review. Of the 49 individual cases reviewed, 25 (51%) were male and 24 (49%) were female. The patients' ages ranged from 16 to 91 years, with a mean age of 53.4 years. Abdominal pain and diarrhea were the chief complaints reported in 37/49 (76%) and 35/49 (71%) cases, respectively. About 42/49 (86%) cases were effectively treated with antibiotics, while some cases required fecal microbiota transplantation or surgical exploration. Given its grave course, CDE warrants prompt and appropriate treatment to prevent complications such as fulminant enteritis, compartment syndrome, and bowel perforation.
期刊介绍:
The Scandinavian Journal of Gastroenterology is one of the most important journals for international medical research in gastroenterology and hepatology with international contributors, Editorial Board, and distribution