CLOSTRIDIUM DIFFICILE COLITIS SHOWED AN APHTHOID EROSION WITHOUT ANY PSEUDOMEMBRANOUS LESION

Abstract

The endoscopic diagnosis of Clostridium difficile colitis(CDC) with the existence of a pseudomembrane has been well-recognized, but the endoscopic images of CDC have been varied. We should therefore not persist in basing the diagnosis of CDC on the finding of the pseudomembrane. In the present study we report on 9 cases of CDC which showed an aphthoid erosion, but without any pseudomembranous lesion. However the meaning of the existence of an aphthoid erosion in CDC is not clear, and we thus investigated these 9 cases to elicit any such significance. The clinical manifestations of CDC with aphthoid erosions were mild, so that the presence of an aphthoid erosion indicated a mild case of CDC. When in doubt regarding a diagnosis of CDC with an aphthoid erosion without a pseudomembranous lesion, we should perform anaerobic cultures to identify the CDC-related toxin to confirm the diagnosis and decide on the treatment.