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1994-10-08
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Document 0291
DOCN M94A0291
TI Etiology and management of toxic megacolon in patients with human
immunodeficiency virus infection.
DT 9412
AU Beaugerie L; Ngo Y; Goujard F; Gharakhanian S; Carbonnel F; Luboinski J;
Malafosse M; Rozenbaum W; Le Quintrec Y; Department of Gastroenterology,
Hopital Rothschild, Paris,; France.
SO Gastroenterology. 1994 Sep;107(3):858-63. Unique Identifier : AIDSLINE
MED/94357387
AB We report six cases of toxic megacolon in patients with human
immunodeficiency virus (HIV). One case, at an early stage of HIV
infection, mimicked a severe attack of Crohn's disease, with a negative
search for infectious agents. Subtotal colectomy was successfully
performed with an uneventful postoperative course. The five other cases
concerned patients with acquired immunodeficiency syndrome at a late
stage of immunodeficiency. They were related to Clostridium difficile or
cytomegalovirus (CMV) intestinal infection in two and three patients,
respectively. One case of CMV colitis presented macroscopically and
histologically as pseudomembranous colitis. Emergency subtotal
colectomy, performed in the first four patients with acquired
immunodeficiency syndrome was followed by a fatal postoperative outcome.
The last patient treated conservatively by colonoscopic decompression,
in association with anti-CMV therapy, had a favorable short-term
outcome. From the experience of our series and data from the literature,
we discuss the best diagnostic and therapeutic approach to toxic
megacolon in patients with HIV.
DE Adult Antibiotics/THERAPEUTIC USE Clostridium difficile Colectomy
Colonoscopy Cytomegalovirus Infections/COMPLICATIONS/DRUG THERAPY
Enterocolitis, Pseudomembranous/COMPLICATIONS/DRUG THERAPY Human HIV
Infections/*COMPLICATIONS Male Megacolon,
Toxic/*MICROBIOLOGY/RADIOGRAPHY/*THERAPY Survival Analysis JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).