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Superimposed infections in patients with inflammatory bowel disease (IBD) have drawn considerable attention in the disease managements that can lead to increased rates of colectomy and mortality. We followed a case of an IBD patient with severe bloody diarrhea (more than 10 times a day) and diffuse ulceration in his colon that mimicked a flare-up of IBD. Stool examina - tion showed enteric overgrown enterotoxigenic Staphylococcus aureus (sea +) together with a low count of cytotoxic Clostridium difficile (tcdB +) bacteria. Antibiotic therapy with oral vancomycin as the sole in vitro determined effective drug normalized the patient's clinical features. The patient died of post-surgical septic shock after colectomy that had been conducted because of deterioration of his clinical state one week after the antibiotic therapy. Sudden release of overgrown intestinal S. aureus super - antigens ( sea and peptidoglycan) with regard to the cooperative effect of C. difficile infection was suspected as a predisposing factor for severe disease.

przegląd gastroenterologiczny

Opisy przypadków Coexistence of enterotoxigenic Staphylococcus aureus and cytotoxic Clostridium difficile as predisposing factors for septic shock in patients with inflammatory bowel disease