Summary
In a 4-year period 45 patients were admitted to our gastroenterological unit with
acute infective colitis. The endemic pathogens responsible for the colitis were Yersinia
enterocolitica (46 %), Campylobacter fetus jejuni (20 %), common Salmonellae (13 %),
less virulent strains of Shigella (9 %). Entamoeba hystolytica (7 %) and Cytomegalovirus
(4 %). These microorganisms caused very severe disease in 18 % of the patients, who
were mostly predisposed. While Salmonella- and amoebic colitis always mimicked ulcerative
colitis by the presence of diffuse lesions, the other pathogens caused focal colitis,
thus necessitating differential diagnosis vis a vis Crohn's colitis. Two patients
(4 %) died of complications, while 93 % of the patients were cured by proper antimicrobial
therapy. In the same period 12 patients were admitted with an acute attack of inflammatory
bowel disease due to an intercurrent infection with the same pathogens. In most of
these patients clinical remission of IBD was achieved by treating the intercurrent
infection.
These data indicate that in the presence of an acute attack of colitis an infective
etiologic agent must always be sought, and that an attack of chronic idiopathic inflammatory
bowel disease may be caused by an intercurrent infection.
Key words:
Colitis - Yersinia - Campylobacter - Salmonella - Shigella - Cytomegalovirus - Entamoeba
- Inflammatory bowel disease
