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Infectious Colitis
Atif Zaheer, MD; Gabriela Gayer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Colonic inflammation due to bacterial, viral, fungal, or parasitic infections
            • Pseudomembranous colitis: Descriptive term usually applied to Clostridium difficile colitis

          IMAGING

          • General Features

            • Fluoroscopic Findings

              • CT Findings

                • Imaging Recommendations

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Antonelli M et al: Clostridioides difficile (formerly Clostridium difficile) infection in the critically ill: an expert statement. Intensive Care Med. 46(2):215-24, 2020
                                      2. Azer SA et al: Infectious colitis. StatPearls, 2020
                                      3. Bouza E et al: Recommendations for the diagnosis and treatment of Clostridioides difficile infection: an official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spanish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR). Rev Esp Quimioter. 33(2):151-75, 2020
                                      4. Oksi J et al: Treatment of Clostridioides (Clostridium) difficile infection. Ann Med. 52(1-2):12-20, 2020
                                      5. Deepak P et al: The role of the radiologist in determining disease severity in inflammatory bowel diseases. Gastrointest Endosc Clin N Am. 29(3):447-70, 2019
                                      6. Frickenstein AN et al: Imaging inflammation and infection in the gastrointestinal tract. Int J Mol Sci. 21(1):243, 2019
                                      7. Guerri S et al: Clostridium difficile colitis: CT findings and differential diagnosis. Radiol Med. 124(12):1185-98, 2019
                                      8. Kedia S et al: Differentiating Crohn's disease from intestinal tuberculosis. World J Gastroenterol. 25(4):418-32, 2019
                                      9. Khalili H et al: Case 19-2019: a 38-year-old woman with abdominal pain and fever. N Engl J Med. 380(25):2461-70, 2019
                                      10. de Leijer JH et al: Unexpected amebic colitis presenting with rectal bleeding and perforation after biopsy. Gastrointest Endosc. 88(3):565-6, 2018
                                      11. Gecse KB et al: Differential diagnosis of inflammatory bowel disease: imitations and complications. Lancet Gastroenterol Hepatol. 3(9):644-53, 2018
                                      12. Trad D et al: Acute severe colitis revealing tuberculosis. Gastrointest Endosc. 88(4):777-8, 2018
                                      13. Lin WC et al: Challenges in the diagnosis of ulcerative colitis with concomitant bacterial infections and chronic infectious colitis. PLoS One. 12(12):e0189377, 2017
                                      14. Sharma V et al: Tubercular colitis masquerading as ischemic colitis: an unusual presentation. Int J Mycobacteriol. 6(4):404-6, 2017
                                      15. Yu YR et al: Clinical presentation of Crohn's, ulcerative colitis, and indeterminate colitis: symptoms, extraintestinal manifestations, and disease phenotypes. Semin Pediatr Surg. 26(6):349-55, 2017
                                      16. Barina AR et al: Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis. Abdom Radiol (NY). 41(2):207-14, 2016
                                      17. Dekker JP et al: Salmonella, Shigella, and yersinia. Clin Lab Med. 35(2):225-46, 2015
                                      18. Aboutaleb N et al: Emerging infectious colitis. Curr Opin Gastroenterol. 30(1):106-15, 2014
                                      19. Burke KE et al: Clostridium difficile infection: a worldwide disease. Gut Liver. 8(1):1-6, 2014
                                      20. Raman SP et al: MDCT and CT angiography evaluation of rectal bleeding: the role of volume visualization. AJR Am J Roentgenol. 201(3):589-97, 2013
                                      21. Ninan S et al: The young patient with acute bloody diarrhoea. Acute Med. 13(2):90-6, 2014
                                      22. Antonopoulos P et al: An emergency diagnostic dilemma: a case of Yersinia enterocolitica colitis mimicking acute appendicitis in a beta-thalassemia major patient: the role of CT and literature review. Emerg Radiol. 15(2):123-6, 2008
                                      23. Thoeni RF et al: CT imaging of colitis. Radiology. 240(3):623-38, 2006
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Colonic inflammation due to bacterial, viral, fungal, or parasitic infections
                                                • Pseudomembranous colitis: Descriptive term usually applied to Clostridium difficile colitis

                                              IMAGING

                                              • General Features

                                                • Fluoroscopic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      • Ultrasonographic Findings

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Antonelli M et al: Clostridioides difficile (formerly Clostridium difficile) infection in the critically ill: an expert statement. Intensive Care Med. 46(2):215-24, 2020
                                                                          2. Azer SA et al: Infectious colitis. StatPearls, 2020
                                                                          3. Bouza E et al: Recommendations for the diagnosis and treatment of Clostridioides difficile infection: an official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spanish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR). Rev Esp Quimioter. 33(2):151-75, 2020
                                                                          4. Oksi J et al: Treatment of Clostridioides (Clostridium) difficile infection. Ann Med. 52(1-2):12-20, 2020
                                                                          5. Deepak P et al: The role of the radiologist in determining disease severity in inflammatory bowel diseases. Gastrointest Endosc Clin N Am. 29(3):447-70, 2019
                                                                          6. Frickenstein AN et al: Imaging inflammation and infection in the gastrointestinal tract. Int J Mol Sci. 21(1):243, 2019
                                                                          7. Guerri S et al: Clostridium difficile colitis: CT findings and differential diagnosis. Radiol Med. 124(12):1185-98, 2019
                                                                          8. Kedia S et al: Differentiating Crohn's disease from intestinal tuberculosis. World J Gastroenterol. 25(4):418-32, 2019
                                                                          9. Khalili H et al: Case 19-2019: a 38-year-old woman with abdominal pain and fever. N Engl J Med. 380(25):2461-70, 2019
                                                                          10. de Leijer JH et al: Unexpected amebic colitis presenting with rectal bleeding and perforation after biopsy. Gastrointest Endosc. 88(3):565-6, 2018
                                                                          11. Gecse KB et al: Differential diagnosis of inflammatory bowel disease: imitations and complications. Lancet Gastroenterol Hepatol. 3(9):644-53, 2018
                                                                          12. Trad D et al: Acute severe colitis revealing tuberculosis. Gastrointest Endosc. 88(4):777-8, 2018
                                                                          13. Lin WC et al: Challenges in the diagnosis of ulcerative colitis with concomitant bacterial infections and chronic infectious colitis. PLoS One. 12(12):e0189377, 2017
                                                                          14. Sharma V et al: Tubercular colitis masquerading as ischemic colitis: an unusual presentation. Int J Mycobacteriol. 6(4):404-6, 2017
                                                                          15. Yu YR et al: Clinical presentation of Crohn's, ulcerative colitis, and indeterminate colitis: symptoms, extraintestinal manifestations, and disease phenotypes. Semin Pediatr Surg. 26(6):349-55, 2017
                                                                          16. Barina AR et al: Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis. Abdom Radiol (NY). 41(2):207-14, 2016
                                                                          17. Dekker JP et al: Salmonella, Shigella, and yersinia. Clin Lab Med. 35(2):225-46, 2015
                                                                          18. Aboutaleb N et al: Emerging infectious colitis. Curr Opin Gastroenterol. 30(1):106-15, 2014
                                                                          19. Burke KE et al: Clostridium difficile infection: a worldwide disease. Gut Liver. 8(1):1-6, 2014
                                                                          20. Raman SP et al: MDCT and CT angiography evaluation of rectal bleeding: the role of volume visualization. AJR Am J Roentgenol. 201(3):589-97, 2013
                                                                          21. Ninan S et al: The young patient with acute bloody diarrhoea. Acute Med. 13(2):90-6, 2014
                                                                          22. Antonopoulos P et al: An emergency diagnostic dilemma: a case of Yersinia enterocolitica colitis mimicking acute appendicitis in a beta-thalassemia major patient: the role of CT and literature review. Emerg Radiol. 15(2):123-6, 2008
                                                                          23. Thoeni RF et al: CT imaging of colitis. Radiology. 240(3):623-38, 2006