ABSTRACT
Bacterial colitis results in an inflammatory-type diarrhea that is characterized by bloody, purulent, and mucoid stool. These diseases have been designated as bacterial hemorrhagic enterocolitis. Associated symptoms include fever, tenesmus, and severe abdominal pain. The pathologic changes range from superficial exudative enterocolitis to a transmural enterocolitis with ulceration. Common pathologic bacteria causing bacterial colitis include Campylobacter , Salmonella , Shigella , Escherichia , and Yersinia species. The primary source of transmission is fecal-oral spread and ingestion of contaminated food and water. Although detailed history and identification of specific risk factors assist in the diagnosis, definitive diagnosis requires bacterial identification. Therefore, the physician must be familiar with the disease pathophysiology, epidemiology, and specific diagnostic modalities for clinical diagnosis and management. Specific tests are used to detect enteric pathogens and include stool and rectal swab culture, histology, and identification of specific bacterial toxins. Although many of these bacterial colitis infections are self-limiting, antibiotics should be used for high-risk patients and patients with complicated disease.
KEYWORDS
Bacteria - colitis - diarrhea - dysentery
REFERENCES
1
Ilnyckyj A.
Clinical evaluation and management of acute infectious diarrhea in adults.
Gastroenterol Clin North Am.
2001;
30
599-609
2
Ryan C A, Nickels M, Hargrett-Bean N T et al..
Massive outbreak of antimicrobial-resistant salmonellosis traced to pasteurized milk.
JAMA.
1987;
258
3269-3274
3
MacKenzie W R, Schell W L, Blair K A et al..
Massive outbreak of waterborne cryptosporidium infection in Milwaukee, Wisconsin: recurrence of illness and risk of secondary transmission.
Clin Infect Dis.
1995;
21
57-62
4
Ina K, Kusugami K, Ohta M.
Bacterial hemorrhagic enterocolitis.
J Gastroenterol.
2003;
38
111-120
5
Macdonald K L, O'Leary M J, Cohen M L et al..
Escherichia coli O157:H7, an emerging gastrointestinal pathogen. Results of a one-year, prospective, population-based study.
JAMA.
1988;
259
3567-3570
6
Peterson M C.
Clinical aspects of Campylobacter jejuni infections in adults.
West J Med.
1994;
161
148-152
7
Ebringer A, Wilson C.
HLA molecules, bacteria and autoimmunity.
J Med Microbiol.
2000;
49
305-311
8
Altekruse S F, Stern N J, Fields P I, Swerdlow D L.
Campylobacter jejuni -an emerging foodborne pathogen.
Emerg Infect Dis.
1999;
5
28-35
9
Jacobs B C, van Doorn P A, Schmitz P I et al..
Campylobacter jejuni infections and anti-GM1 antibodies in Guillain-Barré syndrome.
Ann Neurol.
1996;
40
181-187
10
Loss R W, Mangla J C, Pereira M.
Campylobacter colitis presenting as inflammatory bowel disease with segmental colonic ulcerations.
Gastroenterology.
1980;
79
138-140
11
Matsumoto T, Iida M, Kimura Y, Fujishima M.
Culture of colonoscopically obtained biopsy specimens in acute infectious colitis.
Gastrointest Endosc.
1994;
40
184-187
12
Oldfield E C, Wallace M R.
The role of antibiotics in the treatment of infectious diarrhea.
Gastroenterol Clin North Am.
2001;
30
817-836
13
Smith K E, Besser J M, Hedberg C W et al..
Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998.
N Engl J Med.
1999;
340
1525-1532
14
Levine M M.
Antimicrobial therapy for infectious diarrhea.
Rev Infect Dis.
1986;
8
S207-S216
15
Hoffner R J, Slaven E, Perez J, Magana R N, Henderson S O.
Emergency department presentations of typhoid fever.
J Emerg Med.
2000;
19
317-321
16
Hohmann E L.
Nontyphoidal salmonellosis.
Clin Infect Dis.
2001;
32
263-269
17
Chaudhuri A, Bekdash B A.
Toxic megacolon due to Salmonella : a case report and review of the literature.
Int J Colorectal Dis.
2002;
17
275-279
18
Musher D M, Rubenstein A D.
Permanent carriers of nontyphosa salmonellae.
Arch Intern Med.
1973;
132
869-872
19
Cariani G, Vandelli A.
Salmonellosis-induced hemorrhage and ulcerations of the colon.
Endoscopy.
1993;
25
488
20
Dagash M, Hayek T, Guallimidi Z, Yassin K, Brook J G.
Transient radiological and colonoscopic features of inflammatory bowel disease in a patient with severe Salmonella gastroenteritis.
Am J Gastroenterol.
1997;
92
349-351
21
Kamath R.
Antibiotic therapy for Salmonella enteritis.
J Paediatr Child Health.
1999;
35
372-374
22
Sanchez C, Garcia-Restoy E, Garau J et al..
Ciprofloxacin and trimethoprim-sulfamethoxazole versus placebo in acute uncomplicated Salmonella enteritis: a double-blind trial.
J Infect Dis.
1993;
168
1304-1307
23
Rodriguez-Noriega E, Andrade-Villanueva J, Amaya-Tapia G.
Quinolones in the treatment of Salmonella carriers.
Rev Infect Dis.
1989;
11
S1179-S1187
24
Kotloff K L, Winickott J P, Ivanoff B et al..
Global burden of Shigella infections: implications for vaccine development and implementation of control strategies.
Bull World Health Organ.
1999;
77
651-666
25
DuPont H L, Hornick R B, Snyder M J, Libonati J P, Formal S B, Gangarosa E J.
Immunity in shigellosis. II. Protection induced by oral live vaccine or primary infection.
J Infect Dis.
1972;
125
12-16
26
Mohle-Boetani J C, Stapleton M, Finger R et al..
Community wide shigellosis: control of an outbreak and risk factors in child day-care centers.
Am J Public Health.
1995;
85
812-816
27
O'Sullivan B, Delpech V, Pontivivo G et al..
Shigellosis linked to sex venues, Australia.
Emerg Infect Dis.
2002;
8
862-864
28
Sandvig K.
Shigatoxins.
Toxicon.
2001;
39
1629-1635
29
Bennish M L.
Potentially lethal complications of shigellosis.
Rev Infect Dis.
1991;
13
S319-S324
30
Tsuchiya N, Husby G, Williams R C et al..
Autoantibodies to the HLA-B27 sequence cross-react with the hypothetical peptide from the arthritis-associated Shigella plasmid.
J Clin Invest.
1990;
86
1193-1203
31
Speelman P, Kabir I, Islam M.
Distribution and spread of colonic lesions in Shigellosis : a colonoscopic study.
J Infect Dis.
1984;
150
899-903
32
Khuroo M S, Mahajan R, Zargar S A et al..
The colon in Shigellosis : serial colonoscopic appearances in Shigella dysenteriae . I.
Endoscopy.
1990;
22
35-38
33
Lawson J M.
Update on Escherichia coli O157:H7.
Curr Gastroenterol Rep.
2004;
6
297-301
34
Tarr P I, Neill M A.
Escherichia coli O157:H7.
Gastroenterol Clin North Am.
2001;
30
735-751
35 Griffin P, Mead P, Sivapalasingam S.
Escherichia coli O157:H7 and other enterohemorrhagic E. coli
. In: Blaser M, Smith P, Greenberg H, et al Infections of the Gastrointestinal Tract. Philadelphia; Lippincott Williams & Wilkins 2002: 627-642
36
Huang D, Okhuysen P, Jiang Z et al..
Enteroaggregative Escherichia coli : an emerging enteric pathogen.
Am J Gastroenterol.
2004;
99
383-389
37
Moake J L.
Thrombotic microangiopathies.
N Engl J Med.
2002;
347
589-600
38
Crump J A, Sulka A C, Langer A J et al..
An outbreak of Escherichia coli O157:H7 infections among visitors to a dairy farm.
N Engl J Med.
2002;
347
555-560
39
Shigeno T, Akamatsu T, Fujimori K, Nakatsuji Y, Nagata A.
The clinical significance of colonoscopy in hemorrhagic colitis due to enterohemorrhagic Escherichia coli O157:H7 infection.
Endoscopy.
2002;
34
311-314
40
Kelly J, Oryshak A, Wenetsek M, Grabiec J, Handy S.
The colonic pathology of Escherichia coli O157:H7 infection.
Am J Surg Pathol.
1990;
14
87-92
41
Miller F H, Ma J J, Scholz F J.
Imaging features of enterohemorrhagic Escherichia coli colitis.
AJR Am J Roentgenol.
2001;
177
619-623
42
Proulx F, Turgeon J, Delage G et al..
Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritis.
J Pediatr.
1992;
121
299-303
43
Carter A O, Borczyk A, Carlson J et al..
A severe outbreak of Escherichia coli O157:H7 associated hemorrhagic colitis in a nursing home.
N Engl J Med.
1987;
317
1496-1500
44
Ostroff S M, Kobayashi J M, Lewis J H.
Infections of Escherichia coli O157:H7 in Washington State, the first year of statewide disease surveillance.
JAMA.
1989;
262
355-359
45
Ryan C A, Tauxe R, Hosek G et al..
Escherichia coli O157:H7 diarrhea in a nursing home: clinical, epidemiological, and pathological findings.
J Infect Dis.
1986;
154
631-638
46
Karch H, Strockbine N A, O'Brien A D.
Growth of Escherichia coli in the presence of trimethoprim-sulfamethoxazole facilitates detection of shiga-like toxin producing strains by colony blot assay.
FEMS Microbiol Lett.
1986;
35
141-145
47
Zhang X, McDaniel A, Wolf L et al..
Quinolone antibiotics induce shiga toxin-encoding bacteriophages, toxin production, and death in mice.
J Infect Dis.
2000;
181
664-670
48
Cimolai N, Carter J, Morrison B et al..
Risk factors for the progression of Escherichia coli O157:H7 enteritis to hemolytic-uremic syndrome.
J Pediatr.
1990;
116
589-592
49
Cribier B, Caille A, Heid E, Grosshans E.
Erythema nodosum and associated diseases. A study of 129 cases.
Int J Dermatol.
1998;
37
667-672
50
Kato Y, Hattori Y, Ohya H, Yoshino S, Kato H.
Acute terminal ileitis and Yersinia enterocolitica infection.
Gastroenterol Jpn.
1977;
12
36-43
51
Matsumoto T, Iida M, Matsui T et al..
Endoscopic findings in Yersinia enterocolitica enterocolitis.
Gastrointest Endosc.
1990;
36
583-587
52
Tuohy A M, O'Gorman M, Byington C, Reid B, Jackson W D.
Yersinia enterocolitis mimicking disease in a toddler.
Pediatrics.
1999;
104
36
53
Pham J, Bell S, Lanzarone J.
Biotype and antibiotic sensitivity of 100 clinical isolates of Yersinia enterocolitica.
.
J Antimicrob Chemother.
1991;
28
13-18
54
Preston M A, Brown S, Borczyk A et al..
Antimicrobial susceptibility of pathogenic Yersinia enterocolitica isolated from Canada from 1972 to 1990.
Antimicrob Agents Chemother.
1994;
38
2121-2124
55
Scavizzi M R, Alonso J, Philippon A, Jupeau-Vessieres A M, Guiyoule A.
Failure of newer β-lactam antibiotics for murine Yersinia enterocolitica infection.
Antimicrob Agents Chemother.
1987;
31
523-526
56
Han J K, Kim S H, Choi B I, Yeon K M, Han M C.
Tuberculous colitis: findings at double-contrast barium enema examination.
Dis Colon Rectum.
1996;
39
1204-1209
57
Horvath K D, Whelan R L, Weinstein S, Basner A L, Staugaitis S M, Greenebaum E.
Isolated sigmoid tuberculosis. Report of a case.
Dis Colon Rectum.
1995;
38
1327-1330
58
Breiter J R, Hajjar J J.
Segmental tuberculosis of the colon diagnosed by colonoscopy.
Am J Gastroenterol.
1981;
76
369-373
59 Anand B. Abdominal tuberculosis . In: Weinstein WM, Hawkey CJ, Bosch J Clinical Gastroenterology and Hepatology. Philadelphia; Elsevier Mosby 2005: 331-336
60
Guth A A, Kim U.
The reappearance of abdominal tuberculosis.
Surg Gynecol Obstet.
1991;
172
432-436
61
Lisehora G B, Peters C C, Lee Y T, Barcia P J.
Tuberculous peritonitis-do not miss it.
Dis Colon Rectum.
1996;
39
394-399
62
Quinn T C, Goodell S E, Mkrtichian E, Schuffler M D, Wang S P, Stamm W E.
Chlamydia trachomatis proctitis.
N Engl J Med.
1981;
305
195-200
63
Tinmouth J, Rachlis A, Wesson T, Hsieh E.
Lymphogranuloma venereum in North America: case reports and an update for gastroenterologists.
Clin Gastroenterol Hepatol.
2006;
4
469-473
64
Rompalo A M.
Diagnosis and treatment of sexually acquired proctitis and proctocolitis: an update.
Clin Infect Dis.
1999;
28
S84-S90
65
Catterall R D.
Sexually transmitted disease of the anus and rectum.
Clin Gastroenterol.
1975;
4
659-669
66 Corman M L. Colon and rectal surgery. 5th ed. Philadelphia; Lippincott Williams & Wilkins 2005: 1648-1650
67
Schwebke J R, Whittington W, Rice R J, Handsfield H H, Hale J, Holmes K K.
Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985-1991.
Antimicrob Agents Chemother.
1995;
39
917-920
Harry T PapaconstantinouM.D.
Department of Surgery, Division of Surgical Oncology, Section of Colon and Rectal Surgery, The Texas A&M University System Health Science Center, Scott and White Hospital
2401 South 31st St., Temple, TX 76508
Email: hpapaconstantinou@swmail.sw.org