Thinking beyond the colon-small bowel Involvement in clostridium difficile infection 英文参考文献.docVIP

Gut Pathogens BioMedCentral Review Open Access Thinking beyond the colon-small bowel Involvement in clostridium difficile infection Udayakumar Navaneethan and Ralph A Giannella* Address: Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Email: Udayakumar Navaneethan - navaneur@; Ralph A Giannella* - ralph.giannella@ * Corresponding author Published: 19 March 2009 Received: 21 January 2009 Accepted: 19 March 2009 Gut Pathogens 2009, 1:7 doi:10.1186/1757-4749-1-7 This article is available from: /content/1/1/7 ? 2009 Navaneethan and Giannella; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Small intestinal Clostridium difficile seems to be increasing in incidence. The spectrum of Clostridium difficile infection (CDI) has definitely expanded with small bowel involvement. They are more frequently reported in patients with inflammatory bowel disease (IBD) who have undergone total colectomy or patients with Ileal anal pouch anastomosis. The most common presentation is increased ileostomy output with associated dehydration. High clinical suspicion, early recognition and appropriate treatment are the keys to successful resolution. The increase in the number of these patients may actually reflect an increase in the rising incidence of CDI in general or increasing virulence of the organism. Heightened public awareness and initiation of prompt preventive measures are the keystones to control of this infection. This disease is no longer limited to the colon and physicians should be educated to think beyond the colon in patients with CDI. Review Clostridium renal failure with a blood urea ni