RECTAL HISTOPATHOLOGY IN ENDEMIC SHIGELLA AND SALMONELLA DIARRHEA
RECTAL HISTOPATHOLOGY IN ENDEMIC SHIGELLA AND SALMONELLA DIARRHEA
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DOI：
10.1097/00005176-199301000-00006
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发表时间：
1993-01-01
影响因子：
2.9
通讯作者：
PURI, RK
中科院分区：
文献类型：
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作者：
SACHDEV, HPS;CHADHA, V;PURI, RK
对34例（2个月~ 12岁）地方性“侵袭性腹泻”患者的直肠组织病理学进行了评价[粪便显微镜检查每个高倍视野>20个WBC，有（RBC阳性）或无（RBC阴性）相关RBC]，其中S.紫茎泽兰属（n = 9），S.福氏杆菌（n = 11）和非伤寒沙门氏菌被分离为唯一可识别的肠道病原体。持续性腹泻（>14天）更常见于沙门氏菌感染，而RBC阳性的“侵袭性腹泻”更常见于志贺氏菌，特别是沙门氏菌。大肠杆菌（所有病例）感染。组织病理学特征在很大程度上与感染性结肠炎的早期描述相当，仅根据直肠组织学无法确定感染微生物的性质。其他值得注意的特征如下：（i）在志贺氏菌和沙门氏菌感染中均出现轻度隐窝变形（26%）和分支（21%）;在沙门氏菌感染中，腺体扩张明显更大，伴有持续性腹泻;（ii）62%的患者存在慢性炎性细胞单独或与中性粒细胞联合存在;主要的嗜中性粒细胞反应在沙门氏菌感染中明显更高。假膜形成（6例，18%），特别是在沙门氏菌感染和急性表现。寄生虫病（4例）;和（iv）嗜中性粒细胞反应、水肿和固有层血管内的中性粒细胞以及腺体中的粘蛋白耗竭与RBC阳性“侵袭性腹泻”的显著相关性。''
Rectal histopathology was evaluated in 34 cases (2 months-12 yrs old) of endemic ''invasive diarrhea'' [>20 WBCs per high-power field on stool microscopy with (RBC positive) or without (RBC negative) associated RBCs] where S. dysenteriae (n = 9), S. flexneri (n = 11), and nontyphoidal Salmonella were isolated as the sole identifiable enteropathogens. Persistent diarrhea (>14 days duration) was more common with Salmonella infection whereas RBC-positive ''invasive diarrhea'' was more frequent with Shigella, particularly S. dysenteriae (all cases) infection. The histopathological profile was comparable to the earlier descriptions of infective colitis to a large extent and the nature of the infecting organism could not be determined on the basis of rectal histology alone. The other noteworthy features were as follows: (i) mild crypt distortion (26%) and branching (21%) in both Shigella and Salmonella infection; in Salmonella infection, dilation of the glands was significantly greater with persistent diarrhea; (ii) presence of chronic inflammatory cells either alone or in combination with neutrophils in 62%; a predominant neutrophilic response was significantly higher with S. dysenteriae infection and an acute presentation; (iii) pseudomembrane formation (six subjects; 18%) especially in S. dysenteriae (four cases); and (iv) a significant association of neutrophilic response, edema, and neutrophils within the vessels in the lamina propria and mucin depletion in the glands with RBC-positive ''invasive diarrhea.''