Antibiotic-associated acute necrotizing esophagitis

Mangan, Thomas F.; Colley, Abigail; Wytock, Dale H.

doi:10.1016/0016-5085(90)90997-f

Cited by 52 publications

(46 citation statements)

References 3 publications

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“…6 Antibiotic therapy in AEN is controversial. While some authors believe that antibiotic therapy may predispose the patient to the development of black esophagus, 24 we did not fi nd an increased incidence of death or complications in patients receiving anti microbial medications. However, antibiotic use in AEN should be directed at covering a specifi c pathogen that is found on the analysis of the biopsy specimen.…”

Section: Discussioncontrasting

confidence: 55%

Acute esophageal necrosis: a rare syndrome

et al. 2007

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This study provides a structured approach to identifying risk factors, diagnosis, and pathogenesis of the acute esophageal necrosis. Risk factors include age, male sex, cardiovascular disease, hemodynamic compromise, gastric outlet obstruction, alcohol ingestion, malnutrition, diabetes, renal insufficiency, hypoxemia, hypercoagulable state, and trauma. Mechanism of damage is usually multifactorial secondary to ischemic compromise, acute gastric outlet obstruction, and malnutrition. Overall, acute esophageal necrosis should be viewed as a poor prognostic factor, associated with high mortality from the underlying clinical disease.

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Section: Discussioncontrasting

confidence: 55%

Acute esophageal necrosis: a rare syndrome

et al. 2007

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“…[9] With regard to Stevens-Johnson syndrome and broad spectrum antibiotic-induced NE, it seems odd that the injury from these two could result in pathology isolated to the esophagus. If these were major causes, more cases of NE should be found in the literature given the relative frequency of Stevens-Johnson syndrome and the ubiquitous use of broad-spectrum antibiotics [7,11]. We propose that broad-spectrum antibioticinduced NE may be due to an opportunistic infection in the esophagus similar to that associated with antibiotic-induced colitis in the large bowel.…”

Section: Discussionmentioning

confidence: 96%

“…The discovery of black esophagus, without other clinical information, should prompt the endoscopist to entertain a variety of diagnoses (Table 1) [1][2][3][4][5][6][7][8][9][10][11]. The most acutely lethal of these is necrotizing esophagitis (NE) which should be ruled out promptly with a confirmatory biopsy [2].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing esophagitis presenting as a black esophagus

et al. 1998

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“…Sur le plan étiologique, l'oesophagite nécrosante a été rapportée en association avec les antibiotiques à large spectre [9], l'hyperglycémie (comme dans notre observation) [10], les lésions malignes [7,10], l'infection herpétique [11,12], le volvulus gastrique [13], le syndrome Stevens-Johnson [14], les vomissements sévères après excès d'alcool [15] et l'état de choc [16]. À notre connaissance, aucune association d'oesophagite nécrosante avec le scorbut ou avec une lésion hypophysaire n'a été rapportée.…”

Section: Discussionunclassified

À propos d’un nouveau cas d’oesophage noir

Diffaa¹,

Samlani²,

El-Anssari

et al. 2010

Acta Endosc

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Introduction : L'oesophagite aiguë nécrosante est une urgence rare. Observation : Patiente de 46 ans, diabétique insulinodépen-dante, qui consultait pour hématémèse, méléna et hématurie macroscopique, associés à des lésions cutanées nécrotiques des membres. L'examen trouvait un bon état hémodyna-mique, un gigantisme sans acromégalie, des lésions cutanées à type de décollement cutané nécrotique. L'endoscopie montrait un aspect d'« oesophage noir » dont la biopsie pré-sentait une nécrose de la muqueuse et de la sous-muqueuse. La biologie notait une glycémie de 3 g/l, une hyperleucocytose à polynucléaire neutrophile, une hypoascorbémie et une insuffisance gonadotrope hypogonadotrophique et hypothyréotrope. La biopsie des lésions cutanées concluait à une angéite leucoclastique. L'IRM cérébrale objectivait un macroadénome totalement kystisé. Le traitement consistait en une équilibration du diabète, vitaminothérapie, traitement hormonal thyroïdien et une antibiothérapie. Le contrôle endoscopique notait une régression totale de la nécrose oesophagienne. La patiente a présenté au cours de l'hospitalisation une embolie pulmonaire massive qui a causé son décès. Discussion : L'incidence d'oesophagite aiguë nécrosante est estimée de 0,008 à 0,2 %. Son diagnostic est purement endoscopique (oesophage noir). Conclusion : À notre connaissance, notre description de cas est la première qui rapporte son association avec un scorbut et un macroadénome hypophysaire. Pour citer cette revue : Acta Endosc. 40 (2010). Mots clés OEsophagite · Nécrose · Scorbut · MacroadénomeAbstract Introduction: Acute necrotising oesophagitis is an uncommon emergency condition. Case report: A 46-year-old insulin dependent, diabetic woman presented with haematemesis, melaena and macroscopic haematuria, in association with necrotic cutaneous lesions of the limbs. On examination, she was haemodynamically stable, appeared to have giantism without acromegalic features and exhibited bullous skin necrosis. Endoscopy showed the appearances of "black oesophagus" with biopsy revealing mucosal and submucosal necrosis. Blood tests yielded a glucose level of 3 g/l, polymorph leucocytosis, a low ascorbic acid level, hypogonadotrophic hypogonadism and low TSH. Biopsy of the cutaneous lesions demonstrated leucocytoclastic angiopathy. Cerebral MRI showed a completely cystic macroadenoma. Treatment comprised control of her diabetes, vitamin therapy, thyroid hormone replacement and antibiotics. On repeat endoscopy, the oesophageal necrosis had completely disappeared. During her hospital stay, she had a massive fatal pulmonary embolus. Discussion: The incidence of acute necrotising oesophagitis is thought to be between 0.008% and 0.2%. The diagnosis depends on endoscopy (black oesophagus). Conclusion: As far as we know, this is the first report of its association with vitamin C deficiency and a pituitary macroadenoma. To cite this journal: Acta Endosc. 40 (2010).

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Antibiotic-associated acute necrotizing esophagitis

Cited by 52 publications

References 3 publications

Acute esophageal necrosis: a rare syndrome

Acute esophageal necrosis: a rare syndrome

Necrotizing esophagitis presenting as a black esophagus

À propos d’un nouveau cas d’oesophage noir

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