Severe pseudomembranous colitis in a patient after COVID-19. MCSC patient history
NewsIn the MCSC named after A. S. Loginov, a patient P., 64 years old, complained of:
- frequent watery stools up to 15 times a day;
- marked weakness;
- an increase in body temperature to 38C.
In February 2021, she was hospitalized with bilateral pneumonia caused by COVID-19. She was treated for a new coronavirus infection, including she received antibacterial therapy, after which she noted frequent loose stools.
When contacting our center, pseudomembranous colitis is suspected. This is a disease of the large intestine, characterized by inflammation and increased formation of white-yellow plaques (pseudomembranes) on the surface of the intestinal mucosa. The patient was hospitalized in the Department of treatment of inflammatory bowel diseases.
In laboratory diagnostics, doctors paid attention to:
- decrease in protein, iron, hemoglobin, increase in leukocytes in blood tests;
- toxins A and B of Clostridium difficile in the analysis of feces.
A colonoscopy was performed without preparation (fig. 1). the photo shows that the mucous membrane throughout the colon is overflowing with blood (hyperemic), edematous, with multiple whitish-yellow overlays like films, easily removed mechanically. In the right sections, they almost completely cover the intestinal wall.
The patient was prescribed therapy for pseudomembranous colitis, against which a clinical improvement was achieved, a decrease in inflammation. But ten days later, complaints of loose stools resumed, and laboratory markers of the inflammatory process increased in blood tests.
A multidisciplinary council was assembled with the participation of doctors of the Center:
- surgeon-coloproctologist
- nutritionist
- clinical pharmacologist
- gastroenterologist.
The specialists were faced with the question: to operate or continue drug therapy? It was decided to conduct surgical treatment in the amount of the formation of a disabling stoma.
After the operation, the patient's condition improved, laboratory parameters normalized, and she was discharged from the Department.
Currently, the patient continues dynamic observation in the MCSC named after A. S. Loginov:
- a control examination was conducted;
- it is planned to carry out reconstructive surgery with the elimination of the stoma.
Pseudomembranous colitis - a disease caused by the spore-forming anaerobic bacteria Clostridium difficile. Taking antibiotics is one of the main factors that increases the likelihood of infection with this bacterium.
The leading factors of Clostridium difficile pathogenicity are toxic substances produced by the bacterium:
- toxin A and toxin B disrupt the barrier function of the colon mucosa and cause diarrhea,
- an increase in body temperature provokes abdominal pain.
In severe cases, severe inflammation of the intestine develops, which is manifested by fever, diarrhea up to 15 times a day and severe dehydration. This is what happened in our patient.
Unfortunately, it is not always possible to cope with conservative methods of therapy in the treatment of this disease. Our center always uses a multidisciplinary approach in the treatment of each patient.
Dear patients, if you or your relatives are faced with this problem, MCSC doctors are always ready to provide specialized assistance in the treatment of this disease.
