Antibiotic-induced enteritis
Introduction
Introduction to antibiotic-induced enteritis Antibiotic-induced enteritis, also known as antibiotic-associated enteritis, long-term application of broad-spectrum antibiotics can make the intestinal flora imbalance, so that the intestinal resistance of Staphylococcus aureus, Pseudomonas aeruginosa, Proteus, certain Clostridium and white rosary A large number of bacteria and other reproduction causes enteritis. The incidence is mostly after two or three weeks of continuous medication, and there are also as short as several days. Frail, severe primary disease, long-term use of adrenocortical hormone or anticancer drugs, or immunocompromised patients are more likely to develop disease. Infants and young children are more seriously ill. Strict bedside isolation to prevent cross-infection in the hospital, allowing the use of antibiotics or other narrow-spectrum antibiotics. Patients with obvious diarrhea and abdominal pain may be treated with microecological preparations, astringents, and antispasmodic drugs. basic knowledge The proportion of illness: 0.002% Susceptible people: good for infants and young children Mode of infection: fecal-mouth transmission Complications: fungal enteritis
Cause
Antibiotic-induced enteritis
Cause:
Long-term application of broad-spectrum antibiotics can cause intestinal flora imbalance, and the intestinal resistance of Staphylococcus aureus, Pseudomonas aeruginosa, Proteus, certain Clostridium and Candida albicans can cause a large number of intestinal inflammation. Abuse of antibiotics, altered microflora in the intestines, or enteritis caused by antibiotic-resistant strains.
Prevention
Antibiotic-induced enteritis prevention
Abuse of antibiotics, altered microflora in the intestines, or enteritis caused by antibiotic-resistant strains. Therefore, antibiotics should be used rationally to prevent abuse.
Complication
Antibiotic-induced enteritis complications Complications fungal enteritis
Those who are seriously ill can die. Initial colonic mucosa congestion and punctiform hemorrhage, small abscess formation in mucosal crypts. The abscess gradually enlarges, and the surface of the intestinal mucosa is necrotic and shedding, forming a superficial small ulcer and involving the submucosa. Ulcers can be fused or expanded to form a sinus. The lesion develops further, and large intestine mucosa can form necrosis and form a large ulcer. The residual intestinal mucosa is hyperemia, edema and hyperplasia to form a polypoid appearance, called pseudopolyps. The fake polyps are slender, and their pedicles are not significantly different from the body. Sometimes ulcers penetrate the intestinal wall causing abscess around the colon and secondary peritonitis. The colon of the lesion can be adhered to the adjacent abdominal organs.
Symptom
Antibiotic-induced symptoms of enteritis Common symptoms Weak diarrhea, nausea and blood in the stool
1. Staphylococcus aureus enteritis: primary is rare. It is caused by bacteria invading the intestinal wall and producing enterotoxin. The main symptoms are diarrhea, mild diarrhea several times, gradually recover after stopping the drug: severe diarrhea is frequent, stool has a bad smell, yellow or dark green, watery, more mucus, a small amount of bloody stools. Dehydration, electrolyte imbalance and acidosis can occur. Accompanied by abdominal pain and varying degrees of symptoms of poisoning such as fever, nausea, vomiting, fatigue, paralysis, and even shock. There were a large number of pus cells and clusters of Gram-positive cocci in the stool, and the growth of S. aureus was carried out, and the coagulase test was positive.
2. Pseudomembranous enterocolitis: caused by Clostridium difficile. In addition to vancomycin and aminoglycoside antibiotics for external use in the gastrointestinal tract, almost all kinds of antibiotics can induce this disease, which can occur within 1 week of administration or 4 to 6 weeks after drug withdrawal. Also seen in postoperative surgical, intestinal obstruction, intussusception, megacolon and renal failure and other debilitating patients.
The main symptom is diarrhea, mild daily bowel movements several times, and soon after stopping antibiotics, it will heal. Severe diarrhea, stool is yellow or yellow-green, watery, can have a pseudomembrane discharge, a few stools with blood. Dehydration, electrolyte imbalance and acidosis can occur. With abdominal pain, bloating and poisoning symptoms, severe cases can occur in shock. Proctoscopy and sigmoidoscopy are available for suspicious cases.
Stools for anaerobic culture and tissue culture to detect cytotoxins can help diagnose.
3. Fungal enteritis: often caused by Candida albicans, often accompanied by thrush. Increased stool frequency, thin yellow, more foam, with mucus, sometimes visible tofu slag-like fine pieces (colony), occasionally bloody stools, microscopic examination showed fungal bud cells and pseudohyphae. Do stool fungus culture for identification.
Examine
Antibiotic-induced enteritis examination
1. Staphylococcus aureus enteritis: stool microscopic examination has a large number of pus cells and clusters of Gram-positive cocci, cultured with Staphylococcus aureus growth, coagulase test positive.
2. pseudomembranous enterocolitis: anaerobic culture of stool, tissue culture method to detect cytotoxin can help diagnose.
3. Fungal enteritis: microscopic examination showed fungal bud cells and pseudohyphae. Do stool fungus culture for identification.
Diagnosis
Diagnosis and identification of antibiotic-induced enteritis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The disease should be differentiated from ulcerative colitis, colonic Crohn's disease, ischemic enteritis, and AIDS colitis.
