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僞膜性腸炎

Pseudomembranous Staphylococcal Enterocolitis

대한외과학회지 1970년 12권 2호 p.49 ~ 56
한병택,
소속 상세정보
한병택 (  ) - 전남대학교 의과대학 내과학교실

Abstract


Sixteen cases of Pseudomembranous Staphylococcal Enterocolitis, observed at the Chonnam University Hospital and Chonjoo St. Mary´s Hospital during the past four year period from March 1965 to Fed. 1969, were Studied with special reference to the treatment with "Retention Enemas of Normal Fecal Suspensions". Associated preexisting diseases, preceding antibiotic treatment, chief symptoms and signs, laboratory findings, cultrue and sensitivity studies, treatment with normal fecal enemas and pathological findings have been analysed. Two cases of typical case reports were added.
The results obtained were as follows:
(1) The most common associated pre-existing diseases were gastrointestinal lesions for which they received operative interventions. Colonic resections were the largest group with this fatal complication.
(2) The mos frequently employed antibiotics prior to enterocolitis were penicillin plus streptomycin. The others were, in decreasing order of frequency, neomycin plus terramycin, penicillin plus chloramphenical, penicillin plus streptomycin plus terramycin.
(3) All the sixteen cases developed severe choliform diarrhea and some fell into shock, which constituted a major cause of death.
(4) Stool cultures reavealed coagulase positive, staphylococci in all the 16 caes. Sensitivity studies showed the staphylococci to be the most sensitive to novobiocin and erythromycin. The other antibiotics were, in declining order of sensitivity, leucomycin, kanamycin, chloramphenicol and neomycin.
(5) All the usual methods of treatment for the life-threatening, choleriform diarrhea, revealed no specific benefit to the victims. Retention enemas of normal fecal suspension, however, showed dramiatic responses in all the cases for which they were employed. Within six hours the stools became more normal in character and general condition improved rapidly.
(6) We had a little difficulty in convincing the nurses to carry out the order for fecal enemas. This small series is obviously too limited for me to draw any definite conclusions, but I do hope that others will give this simple procedure a trial, so that a more detailed evaluation of its efficiency can be made.

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