SALMONELLA ENTEROCOLITIS WITH PSEUDOMEMBRANE AT THE TERIMINAL ILEUM—RERPORT OF A CASE—

Abstract

Colonic involvement of salmoellosis is rare in literature. Recently we had a case of salmoellosis presenting pseudomembranous changes at the terminal ileum. A 17 year-old man was admitted to our hospital with the sudden onset of diarrhea, abdominal pain and fever since 6th Aug. 1983. Laboratory data on admission were as follows; Blood sedimentation lhr-27 mm, CRP 6+, WBC 11700. Stool culture showed Salmonella B group (Table 1) . Clostridium difcile was negative and he had not been treated by antibiotics. Colonscopic examination revealed mucosal reddness, bleeding and edema from sigmoid colon to hepatic flexure (Fig. 1) . There were not only several shallow irregular ulcer at the ascending colon, but also multiple small yellow-whitish pseudomembrane at terminal ileum and the cecum (Fig. 2) . Histological finding of biopsy specimen showed inflammatory cells and necrotizing substance on the top of the lesion. Clinical course was very good with antibiotic therapy. He was discharged in 3 weeks' admission. Stool culture became completely negative. Pseudomembranous changes were first detected at the terminal ileum by m eans of total colonoscopy which was due to the infection of Salmonella B group for lack of Clostridium diflicile.