INFECTIOUS CAUSES OF DIARRHEA IN THE DIFFERENTIAL-DIAGNOSIS OF INFLAMMATORY BOWEL-DISEASE
INFECTIOUS CAUSES OF DIARRHEA IN THE DIFFERENTIAL-DIAGNOSIS OF INFLAMMATORY BOWEL-DISEASE
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DOI：
10.1016/s0025-7125(16)30584-3
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发表时间：
1990-01-01
影响因子：
5.9
通讯作者：
FARMER, RG
中科院分区：
文献类型：
--
作者：
FARMER, RG
肠炎和结肠炎的感染原因很多。然而，溃疡性结肠炎或克罗恩病的实际临床鉴别诊断通常不是一个重要的问题，当然，除了两种情况：（1）急性腹泻伴或不伴直肠出血，（2）患有艾滋病，免疫功能低下或男性同性恋的患者。然而，如果人们记住直肠出血和粘膜异常是弥漫性和均匀的，是溃疡性结肠炎的标志，克罗恩病有肛周和外部表现作为其重要的临床标志，这两种疾病往往是慢性和复发性的，通常可以作出临床区分。然而，重要的是要认识到，肠道感染的意识越来越高，部分原因是对男性同性恋者或艾滋病患者的研究，以及对其他腹泻感染原因的认识，包括旅行者腹泻，与C。艰难梭菌感染，以及弯曲杆菌感染。然而，正如临床医学中通常的情况一样，仔细和准确的病史，注意体格检查和乙状结肠镜检查的细节，以及实验室（通常是粪便培养）数据将导致适当的诊断。
The infectious causes of enteritis and colitis are numerous. However, the actual clinical differential diagnosis with either ulcerative colitis or Crohn's disease is usually not a significant problem, except, of course, in two circumstances:(1) acute onset of diarrhea with or without rectal bleeding, and (2) patients who have AIDS, are immunocompromised, or are male homosexuals. However, if one bears in mind that rectal bleeding and mucosal abnormalities which are diffuse and uniform are the hallmark of ulcerative colitis, that Crohn's disease has perianal and external manifestations as its significant clinical hallmark, and both diseases tend to be chronic and recurrent, the clinical distinction can usually be made. However, it is important to recognize that there is an increasing awareness of intestinal infections, partly as a result of study of male homosexuals or patients with AIDS, as well as increased recognition of other infectious causes of diarrhea, including traveler's diarrhea, that associated with C. difficile, and that found with infection due to Campylobacter. As is usually the case in clinical medicine, however, careful and accurate history, attention to detail on physical and sigmoidoscopic examination, and laboratory (usually stool culture) data will lead to the appropriate diagnosis.