Analysis of causative agents using biopsy specimens and intraluminal fluid obtained during colonoscopy in patients with acute diarrhea

Woo, Ka Eun; Jung, Sung Ae; Cho, Ji Yoon; Cho, You Kyoung; Song, Ji Hyun; Kim, Doe Young; Yoo, Kwon; Moon, Il Hwan

Abstract

BACKGROUND: The aim of this study was to investigate the value of colonoscopy for assessment of colonic mucosal lesions and for microbial identification in patients with acute diarrhea.
METHODS
From March 2000 to August 2000, forty-one patients with watery or bloody diarrhea lasting less than 15 days were participated after the exclusion of patients who had previous history or presumption of inflammatory bowel disease, radiation colitis, ischemic colitis, or pseudomembranous colitis. Both biopsy specimens and colonic luminal fluid were taken during the colonoscopy and used for bacterial cultures.
RESULTS
Male and female ratio was 22:19 and mean age was 45+/-20 years. The extent of acute colitis was as followed: the normal colonoscopic finding in five cases (12.2%), involvement of one segment in 3 cases (7.3%), involvement of two or more segments in 14 cases (34.1%), pancolitis in 10 cases (24.4%) and pancolitis with terminal ileitis in 9 cases (22.0%). In culture study, identification of more than one pathogen was in 19/41 (46.3%) and the common pathogens were Enterobacter (11 cases), Salmonella species (6 cases), Citrobacter freundii complex (2 cases), Klebsiella oxytoca (2 cases) and Morganella morganii (1 case). Pathogen could be identified in 11.8% with stool specimen, 46.2% with biopsy specimen and 62.5% with intraluminal fluid, but without statistical significance.
CONCLUSION
Colonoscopy was useful in the evaluation of extent and severity of acute infectious colitis. Obtaining the biopsy specimens and intraluminal fluid during colonoscopy seemed to assist in identifying the pathogen in patients with acute diarrhea.