Optimized Protocol for Diagnosis of Acute Ileitis

Garrido, Elena; Sanroman, A. L.; Rodríguez-Gandía, Miguel Ángel; Rivero, Miguel; Royuela, Ana; Moreira, V. F.; Milicua, José

doi:10.1016/j.cgh.2009.07.014

Cited by 9 publications

(17 citation statements)

References 22 publications

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“…In our patient, ileitis CT scan characteristics we observed were common in infection, ischemia or Crohn's disease, but not in lymphoma or systemic lupus erythematosus [13,14]. We did not find evidence for infection or Crohn's disease, as well as cause of transient and reversible ileitis, or drug induced ileitis cause [13,14]. In newborns treated with IVIg who had necrotizing enterocolitis [4,5], symptoms began from 2 h to 96 h after IVIg infusion start, as in our patient.…”

Section: Discussionsupporting

confidence: 40%

“…Such pheochromocytoma complication was not related to our patient’s abdominal pain. In our patient, ileitis CT scan characteristics we observed were common in infection, ischemia or Crohn’s disease, but not in lymphoma or systemic lupus erythematosus [13,14]. We did not find evidence for infection or Crohn’s disease, as well as cause of transient and reversible ileitis, or drug induced ileitis cause [13,14].…”

Section: Discussionmentioning

confidence: 56%

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Reversible ileitis secondary to high dose intravenous immunoglobulin in adult kidney transplant patient treated for acute humoral rejection

Ignace-Girerd

Bouffard

Besset

et al. 2011

Transplant International

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Summary Use of high dose intravenous immunoglobulin (IVIg) has been associated with necrotizing enterocolitis in late‐preterm and term infants treated for severe isoimmune hemolytic jaundice. We present the first adult case of reversible ileitis related to high dose IVIg that occurred during the treatment of acute humoral rejection in a kidney transplant recipient (original nephropathy: lupus). At the third of the 5 days of a 0.4 g/kg/day IVIg infusion, he had periumbilical pain and nausea. Non‐iodine injected abdominal computed tomography (CT) demonstrated a major proximal ileitis that was absent 1 month earlier on a previous CT. After the fourth injection, IVIg therapy was discontinued. Clinical and radiological signs disappeared, respectively, 5 and 7 days after IVIg discontinuation. No other causes of ileitis were diagnosed (especially infectious, vascular, or lupus‐related bowel disease causes). Usual abdominal pain and nausea during IVIg therapy may be related to sub‐clinical ileitis and/or enteritis. As in newborn, such complication has to be diagnosed and IVIg infusion discontinued because of potential evolution to intestinal necrosis.

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Section: Discussionsupporting

confidence: 40%

Section: Discussionmentioning

confidence: 56%

Reversible ileitis secondary to high dose intravenous immunoglobulin in adult kidney transplant patient treated for acute humoral rejection

Ignace-Girerd

Bouffard

Besset

et al. 2011

Transplant International

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“…US can also show pathological changes indicating inflammation in acute ileitis, demonstrating thickening of the bowel wall usually involving one or several loops of distal ileum, in up to 60% of cases [44]. The involved segment is rigid, shows altered peristalsis and abnormal vascularisation, particularly during an active stage of disease.…”

Section: Right Iliac Fossamentioning

confidence: 97%

The role of emergency ultrasound in the diagnosis of acute non-traumatic epigastric pain

et al. 2010

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The epigastrium is the site where pain coming from both abdominal and extra-abdominal organs is frequently referred. Although acute or chronic diseases of the stomach, duodenum, liver, pancreas and biliary tree are the most common causes of acute epigastric pain, several other entities, potentially more severe, should also be suspected and investigated. Clinical bedside ultrasonography (US) is actually the first-line imaging in acute epigastric pain patients presenting to the hospital Emergency Department (ED) because it is rapid, noninvasive, relatively inexpensive and focused, repeatable and reliable. Moreover, the systematic use of emergency US as a complement to routine management might save economic resources by avoiding further costs for complications and substantially reducing the time for making an accurate diagnosis. The purpose of this paper is to review the US spectrum of the most common diseases responsible for acute epigastric pain onset. We also propose a focused, well codified US protocol, that we call the "$ approach", based on our clinical experience and the current literature for acute non-traumatic epigastric pain evaluation in an emergency setting. Its systematic application by the emergency physician may reduce the wait for diagnosis and the over-usage of second-line radiological techniques, including computed tomography, as well as to increase the diagnostic accuracy with potential benefits for patient (safety), physician (efficacy) and the institution (efficiency).

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“…The majority of the cases were reported in patients with various underlying diseases, such as spina bifida, bilateral renal dilatation, and diabetes mellitus. Lastly, SBP occurs in 16% of patients with cirrhosis [226].…”

Section: Other Infectionsmentioning

confidence: 99%

An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

2020

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The genus Aeromonas belongs to the Aeromonadaceae family and comprises a group of Gram-negative bacteria widely distributed in aquatic environments, with some species able to cause disease in humans, fish, and other aquatic animals. However, bacteria of this genus are isolated from many other habitats, environments, and food products. The taxonomy of this genus is complex when phenotypic identification methods are used because such methods might not correctly identify all the species. On the other hand, molecular methods have proven very reliable, such as using the sequences of concatenated housekeeping genes like gyrB and rpoD or comparing the genomes with the type strains using a genomic index, such as the average nucleotide identity (ANI) or in silico DNA–DNA hybridization (isDDH). So far, 36 species have been described in the genus Aeromonas of which at least 19 are considered emerging pathogens to humans, causing a broad spectrum of infections. Having said that, when classifying 1852 strains that have been reported in various recent clinical cases, 95.4% were identified as only four species: Aeromonas caviae (37.26%), Aeromonas dhakensis (23.49%), Aeromonas veronii (21.54%), and Aeromonas hydrophila (13.07%). Since aeromonads were first associated with human disease, gastroenteritis, bacteremia, and wound infections have dominated. The literature shows that the pathogenic potential of Aeromonas is considered multifactorial and the presence of several virulence factors allows these bacteria to adhere, invade, and destroy the host cells, overcoming the immune host response. Based on current information about the ecology, epidemiology, and pathogenicity of the genus Aeromonas, we should assume that the infections these bacteria produce will remain a great health problem in the future. The ubiquitous distribution of these bacteria and the increasing elderly population, to whom these bacteria are an opportunistic pathogen, will facilitate this problem. In addition, using data from outbreak studies, it has been recognized that in cases of diarrhea, the infective dose of Aeromonas is relatively low. These poorly known bacteria should therefore be considered similarly as enteropathogens like Salmonella and Campylobacter.

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Optimized Protocol for Diagnosis of Acute Ileitis

Cited by 9 publications

References 22 publications

Reversible ileitis secondary to high dose intravenous immunoglobulin in adult kidney transplant patient treated for acute humoral rejection

Reversible ileitis secondary to high dose intravenous immunoglobulin in adult kidney transplant patient treated for acute humoral rejection

The role of emergency ultrasound in the diagnosis of acute non-traumatic epigastric pain

An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

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