Atypical presentation of pseudomembranous colitis localized in adenomatous polyps.
The most frequent cause of pseudomembranous colitis is Clostridium difficile (C. difficile) infection. This type of colitis is characterized by an endoscopic pattern of numerous small, yellowish or whitish plaques diffusely distributed, which typically compromises the rectum extending to proximal colon. Occasionally, the pseudomembranes compromise only the transverse or right colon, but their exclusive localization over polyps has not been reported. In this case report we have described a patient with symptoms compatible with C. difficile infection and positive for C. difficile toxigenic culture. Colonoscopy examination showed two small polyps with a whitish surface, and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas. The rest of the colonic mucosa was normal and no other cause was demonstrated. We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C. difficile and/or its toxins.
Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 6510260, Chile.
Cristian
C
Hernández-Rocha
Jonathan
J
Barra-Carrasco
Ana María
AM
Guzmán
Daniel
D
Paredes-Sabja
Gabriel
G
Lezcano
Pablo
P
Zoroquiaín
Manuel
M
Alvarez-Lobos
D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology*; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D015897:Comorbidity; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use
D000890:Anti-Infective Agents; D008795:Metronidazole
Adenomatous polyps; Antibiotic-associated colitis; Clostridium difficile; Clostridium difficile infections; Pseudomembranous colitis