Unusual case of ascites (original) (raw)
Introduction: Clostridium difficile infection is very commonly related to antibiotic therapy. The spectrum of clinical manifestation of C. difficile infection may include, in an increasing order of severity, absence of symptoms, colitis without formation of pseudomembranes and pseudomembranous colitis (PMC). PMC is a severe but rare complication of the infection. It is related to the bacterial production of enterotoxin A and B. Its clinical features include diarrhea, abdominal tenderness and fever. In the worst case, it may progress to toxic megacolon and colonic perforation. Ascites is an infrequent direct complication of most severe cases of PMC. Case Report: We report a case of ascites arising two weeks after the resolution of C. difficile infection, in which hypoalbuminemia, caused by protein losing enteropathy, was the most likely pathogenetic mechanism. The patient recovered completely after human albumin intravenous support and diuretics. Conclusion: Protein losing syndrome r...
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Pseudomembranous colitis (PMC) is characterized by the presence of an inflammatory pseudomembrane overlying the colonic mucosa, and is primarily caused by Clostridium difficile infection (CDI). PMC is often associated with the use of broad-spectrum antibiotics. Common symptoms include watery diarrhea, mucus in stool, abdominal cramps, and fever. We report a case of a 52-year-old female presenting with new abdominal distention, frequent bloody, mucoid, jelly-like diarrhea, and abdominal pain. Peritoneal fluid analysis showed neutrocytic ascites with low serum-ascites albumin gradient (SAAG). A diagnosis of pseudomembranous colitis was confirmed by flexible sigmoidoscopy. However, polymerase chain reaction (PCR) test for Clostridium difficile was negative. The patient was treated with metronidazole (500 mg IV q8h) and vancomycin (250 mg PO QID). Her symptoms resolved after several days of treatment with no ascites found by ultrasound. Neutrocytic ascites can be a complication of PMC. ...
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