Infectious colitis overview: Difference between revisions
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== Epidemiology and Demographics == | == Epidemiology and Demographics == | ||
The exact worldwide incidence and prevalence of infectious colitis is not fully known. However, it is estimated that 2 to 4 billion episodes of [[infectious diarrhea]] (including infectious colitis) occur annually with the largest burden in developing countries. [[Enteric Bacilli|Enteric bacteria]] are the most common [[Pathogen|pathogens]] causing infectious colitis. The highest [[morbidity]] and [[mortality]] from infectious colitis is in children under the age of five years. | |||
==Risk Factors== | ==Risk Factors== | ||
Revision as of 15:08, 2 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
History Perspective
In 1893, J. M. T. Finney described pseudomembranes in the colon of a 22 year old post operative patient. Shigella was first discovered by Dr. Kiyoshi Shiga following a bacillary dysentery outbreak in Japan in 1896. Several outbreaks have occurred since then.
Classification
There is no established classification system for infectious colitis. However, it may be classified based on class of the causative pathogen, route of infection, and duration of symptom. Based on the causative pathogen, infectious colitis may be classified into bacterial, viral, protozoan and fungal.
Pathophysiology
Infectious colitis occurs following invasion of colonic mucosa or attachment to the colonic mucosa by a micro-organism causing inflammation. Enteric pathogens that cause colitis are usually transmitted through fecal-oral route especially in children. Infectious colitis may also occur following antibiotics use, especially broad spectrum antibiotics. Infectious colitis may also be acquired as a sexually transmitted infection (STI) among individuals who practice unsafe anal sex especially among men who have sex with men (MSM).
Causes
The most common pathogens that cause infectious colitis are enteric bacteria. They cause colitis by either directly invading the gut or by causing mucosal injury through toxins they produce without invasion. Common pathogens that cause infectious colitis include Shigella dysenteriae, Escherichia coli, Chlamydia trachomatis, Cytomegalovirus, HSV. Clostridium difficile can cause colitis in individuals on antibiotic therapy.
Differentiating Infectious colitis from other diseases
Symptoms and signs of infectious colitis are seen in other causes of colitis and some systemic diseases. Infectious colitis must be differentiated from other diseases that cause fever, bloody diarrhea, dehydration, tachycardia and low blood pressure. Therefore, detailed history, physical examination and laboratory tests are needed to make the diagnosis. In addition, endoscopy with biopsy may be required to confirm the diagnosis. In infants and young children, infectious colitis must be differentiated from allergic colitis, necrotizing enterocolitis, intussusception, volvulus and early onset inflammatory bowel disease. In adolescents and adults, infectious colitis must be differentiated from inflammatory bowel disease and colorectal malignancy.
Epidemiology and Demographics
The exact worldwide incidence and prevalence of infectious colitis is not fully known. However, it is estimated that 2 to 4 billion episodes of infectious diarrhea (including infectious colitis) occur annually with the largest burden in developing countries. Enteric bacteria are the most common pathogens causing infectious colitis. The highest morbidity and mortality from infectious colitis is in children under the age of five years.