Methicillin-resistant Staphylococcus aureus(MRSA)is responsible for numerous infectious processes.Gastrointestinal tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in Nor...Methicillin-resistant Staphylococcus aureus(MRSA)is responsible for numerous infectious processes.Gastrointestinal tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in North America.We present a case of MRSA colitis in an adult without apparent risk factors.Abdominal computed tomography(CT)showed thickening of the sigmoid colon,indicative of colitis,and empiric therapy with ciprofloxacin and metronidazole was started.Initial work-up for infection-including blood and stool cultures,and stool Clostridium difficile toxin assay-was negative.The patient’s clinical status improved but his diarrhea did not abate.Repetition of stool culture demonstrated luxuriant growth of MRSA sensitive to vancomycin.Oral vancomycin was administered and the patient’s symptoms promptly ceased.展开更多
A 25-year-old man was admitted with the chief complaints of right flank pain,watery diarrhea,and fever.Blood tests revealed high levels of inflammatory markers,and infectious enteritis was diagnosed.A stool culture ob...A 25-year-old man was admitted with the chief complaints of right flank pain,watery diarrhea,and fever.Blood tests revealed high levels of inflammatory markers,and infectious enteritis was diagnosed.A stool culture obtained on admission revealed no growth of any significant pathogens.Conservative therapy was undertaken with fasting and fluid replacement.On day 2 of admission,the fever resolved,the frequency of defecation reduced,the right flank pain began to subside,and the white blood cell count started to decrease.On hospital day 4,the frequency of diarrhea decreased to approximately 5 times per day,and the right flank pain resolved.However,the patient developed epigastric pain and increased blood levels of the pancreatic enzymes.Abdominal computed tomography revealed mild pancreatic enlargement.Acute pancreatitis was diagnosed,and conservative therapy with fasting and fluid replacement was continued.A day later,the blood levels of the pancreatic enzymes peaked out.On hospital day 7,the patient passed stools with fresh blood,and Campylobacter jejuni/coli was detected by culture.Lower gastrointestinal endoscopy performed on hospital day 8 revealed diffuse aphthae extending from the terminal ileum to the entire colon.Based on the findings,pancreatitis associated with Campylobacter enteritis was diagnosed.In the present case,a possible mechanism of onset of pancreatitis was invasion of the pancreatic duct by Campylobacter and the host immune responses to Campylobacter.展开更多
文摘Methicillin-resistant Staphylococcus aureus(MRSA)is responsible for numerous infectious processes.Gastrointestinal tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in North America.We present a case of MRSA colitis in an adult without apparent risk factors.Abdominal computed tomography(CT)showed thickening of the sigmoid colon,indicative of colitis,and empiric therapy with ciprofloxacin and metronidazole was started.Initial work-up for infection-including blood and stool cultures,and stool Clostridium difficile toxin assay-was negative.The patient’s clinical status improved but his diarrhea did not abate.Repetition of stool culture demonstrated luxuriant growth of MRSA sensitive to vancomycin.Oral vancomycin was administered and the patient’s symptoms promptly ceased.
文摘A 25-year-old man was admitted with the chief complaints of right flank pain,watery diarrhea,and fever.Blood tests revealed high levels of inflammatory markers,and infectious enteritis was diagnosed.A stool culture obtained on admission revealed no growth of any significant pathogens.Conservative therapy was undertaken with fasting and fluid replacement.On day 2 of admission,the fever resolved,the frequency of defecation reduced,the right flank pain began to subside,and the white blood cell count started to decrease.On hospital day 4,the frequency of diarrhea decreased to approximately 5 times per day,and the right flank pain resolved.However,the patient developed epigastric pain and increased blood levels of the pancreatic enzymes.Abdominal computed tomography revealed mild pancreatic enlargement.Acute pancreatitis was diagnosed,and conservative therapy with fasting and fluid replacement was continued.A day later,the blood levels of the pancreatic enzymes peaked out.On hospital day 7,the patient passed stools with fresh blood,and Campylobacter jejuni/coli was detected by culture.Lower gastrointestinal endoscopy performed on hospital day 8 revealed diffuse aphthae extending from the terminal ileum to the entire colon.Based on the findings,pancreatitis associated with Campylobacter enteritis was diagnosed.In the present case,a possible mechanism of onset of pancreatitis was invasion of the pancreatic duct by Campylobacter and the host immune responses to Campylobacter.
