Định nghĩa: vi khuẩn xâm lược trực tiếp của đường tiêu hóa với bản phát hành địa phương của một một Enterotoxin) b) giảm bạch cầu trung viêm đại tràng c) nhiễm viêm đại tràng 2. Nguyên nhân a) nhiễm trùng do vi khuẩn: C. difficile b) Nhiễm nấm Candida, Cryptosporidium c) Viral nhiễm trùng | Page 222 F. Infectious complications of the GI tract 1. Definition direct bacterial invasion of the gastrointestinal tract with local release of an a Enterotoxin b Neutropenic colitis c Infectious colitis 2. Etiology a Bacterial infections C. difficile b Fungal infections Candida Cryptosporidium c Viral infections CMV HSV type 1 3. Clinical features a Pain localized at the right iliac fossa typhilitis b Diarrhea 4. Differential diagnosis a Gastritis b Duodenitis or erosion c GVHD d Antibiotic-associated diarrhea 5. Laboratory studies a Chest x-ray or abdominal film revealing peritoneum --------------b Endoscopy or colonoscopy biopsy results by immunoperoxidase staining can provide a result in six hours 79 biopsy for polymerase chain reaction analysis. --------------c Stool for occult blood Hemoccult Blood present in the stool may indicate bacterial infection or inflammation. d Stool for electrolytes Secretory diarrhea usually has an elevated stool sodium. Malabsorption or viral illness usually has a decreased sodium and increased stool osmotic gap 100 mOsm L . e Stool for fecal leukocytes Leukocytes are indicative of bacterial infections. f Stool for ova and parasites and stool culture for enteric pathogens Page 223 6. Management a Broad-spectrum antibiotic therapy including aminoglycosides and metronidazole --------------b Growth factors . granulocyte or granulocyte-macrophage colony-stimulating factor to enhance neutrophil recovery c Surgical debridement may be required in extreme cases. d If endoscopy findings reveal yellow plaques of mucosal edema this is consistent with C. difficile infection. Empiric treatment with vancomycin or metronidazole is recommended. VII. Renal and Hepatic Complications A. Drug-induced renal complications nephrotoxicity -------1. Definition toxic effect of drug s on the kidney resulting in acute tubular necrosis acute tubulointerstitial disease chronic tubulointerstitial disease or glomerulonephritis 2. Etiology Exposure to CsA .
