The role of endoscopy in the diagnosis of infectious colitis

Abstract

The clinical onset of idiopathic inflammatory bowel diseases (IBD) and acute infectious colitis (AIC) is characterized by bloody mucoid diarrhea (1 ) . It is crucial to differentiate between the first and second types of colitis because only an early and correct ethiologic diagnosis allow us to perform a specific medical treatment« The differentiation between the two groups of colitis must be supported by: clinical pictures, stool cultures, endoscopic and hystological findings, §?ool Cu?ture remains the most important diagnostic tool in defining the specific cause of infectious diarrhea (2).However, diagnostically, it has two main limitations: in appropriately equipped laboratories an ethiologic diagnosis can be established for only 42-60% of patients seeking treatment (2,3,4); occasional patients with well defined chronic ulcerative colitis (CUC) have potential pathogens in their stools (3). EOaQscgpic differentj,atign between specific and nonspecific inflammatory bowel diseases may be difficult because the intestinal lining can respond in a limited number of ways to any process that disrupts its integrity (5). Any inflammatory condition that affects the colon may alter the smoothness of the surface lining, may change its colour or may affect the delicate branching vascular pattern; any or all of which may be observed endoscopically. In addition there may be bleeding or ulceration of the mucosa as well as pus or purulent exudate on the surface, or any combination of these (5). Moreover some infections of the colon are primarily mucosal inflammatory processes and thereby produce an endoscopic picture