Hernández-Rocha C, Barra-Carrasco J, Guzmán AM, Paredes-Sabja D, Lezcano G, Zoroquiaín P, Álvarez-Lobos M. Atypical presentation of pseudomembranous colitis localized in adenomatous polyps. World J Gastroenterol 2013; 19(2): 316-318 [PMID: 23345958 DOI: 10.3748/wjg.v19.i2.316]
Corresponding Author of This Article
Dr. Manuel Álvarez-Lobos, Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile. manalvarezl@gmail.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 14, 2013; 19(2): 316-318 Published online Jan 14, 2013. doi: 10.3748/wjg.v19.i2.316
Atypical presentation of pseudomembranous colitis localized in adenomatous polyps
Cristian Hernández-Rocha, Jonathan Barra-Carrasco, Ana María Guzmán, Daniel Paredes-Sabja, Gabriel Lezcano, Pablo Zoroquiaín, Manuel Álvarez-Lobos
Cristian Hernández-Rocha, Manuel Álvarez-Lobos, Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 6510260, Chile
Jonathan Barra-Carrasco, Daniel Paredes-Sabja, Laboratory of Mechanisms of Bacterial Pathogenesis, Department of Biological Sciences, Faculty of Biological Sciences, Universidad Andrés Bello, Santiago 6618000, Chile
Ana María Guzmán, Department of Clinical Laboratory, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 6510260, Chile
Gabriel Lezcano, Pablo Zoroquiaín, Department of Anatomophatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 6510260, Chile
Daniel Paredes-Sabja, Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97333, United States
Author contributions: Hernández-Rocha C, Barra-Carrasco J, Guzman AM, Paredes-Sabja D and Álvarez-Lobos M wrote the paper; Lezcano G and Zoroquiaín P reviewed the histopathological slides.
Correspondence to: Dr. Manuel Álvarez-Lobos, Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile. manalvarezl@gmail.com
Telephone: +56-2-3543820 Fax: +56-2-6397780
Received: July 17, 2012 Revised: September 30, 2012 Accepted: October 16, 2012 Published online: January 14, 2013
Abstract
The most frequent cause of pseudomembranous colitis is Clostridium difficile (C. difficile) infection. This type of colitis is characterized by an endoscopic pattern of numerous small, yellowish or whitish plaques diffusely distributed, which typically compromises the rectum extending to proximal colon. Occasionally, the pseudomembranes compromise only the transverse or right colon, but their exclusive localization over polyps has not been reported. In this case report we have described a patient with symptoms compatible with C. difficile infection and positive for C. difficile toxigenic culture. Colonoscopy examination showed two small polyps with a whitish surface, and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas. The rest of the colonic mucosa was normal and no other cause was demonstrated. We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C. difficile and/or its toxins.
