ABSTRACT
Microscopic colitis [MC] is diagnosed when a patient with chronic watery non-bloody diarrhea [CWND] has an endoscopically normal colon, but colonic biopsies show unique inflammatory changes characteristic of lymphocytic or collagenous colitis. MC is a disorder of unknown etiology. Studies comparing the prevalence of the disease in developing countries as compared to developed countries may shed more light on the possibility of a post-infectious etiology. Most data on the incidence and prevalence of MC are from developed countries where it accounts for 4-13% of cases of CWND. There are only a few reports from developing countries. Two studies from Peru and Tunis, with high prevalence of infectious gastroenteritis, revealed MC in 40% and 29.3% of cases of CWND, respectively. The aim of this study was to investigate the prevalence of MC in patients presenting with CWND in Egypt. A total of 44 patients with CWND of unexplained etiology who had undergone full colonoscopy with no macroscopic abnormalities between January 2000 and January 2010 were assessed retrospectively. The histological appearance of MC was identified in 22 [50%] patients. Twelve [55%] patients were male and 10 [45%] female. Mean age was 40 years [range: 20-65 years]. Twenty [91%] of MC cases had lymphocytic colitis and 2 [9%] had collagenous colitis. The prevalence of MC in Egyptian patients with CWND is high when compared to that in developed countries. MC mainly affects young and middle-aged patients and it is more commonly of the lymphocytic type
ABSTRACT
Hyperacute soft tissue infection is an uncommon infection entity, which mostly affects immunocompromized individuals, mainly diabetics and poses difficult diagnostic and therapeutic management decision. This study addresses the presentation, evaluation and management of 27 diabetic patients with acute necrotizing fasciitis treated throughout the period between August 1993 and July 2003 by the main author. Extremities, trunk and perineum were the most commonly involved sites with an incidence of 37%, 29.6% and 26% respectively. All patients presented with cellulitis, which was associated with edema in 74% of cases, skin gangrene in 48% of cases and brown echymotic patches in 29.6% of cases. skin vesicles, tenderness and creiitations were present in 15%, 11% and 11% of cases respectively. Streptococci, Staphylococci and E-Coli were the most commonly encountered organisms, which affected 70% of cases, either alone or in combination. Anaemia and hypoalbuminaemia were the most commonly encountered laboratory findings in 74% and 85% of cases respectively. The mortality rate in the27 patients included in this study was 44% [12 cases]; in 8 of them infection was located in the truk. Once necrotizing fasciitis is suspected, exploration of the fasica is mandatory with pathological assessment of tissue specimens. Radical debriement of the affected area, maintenance of adequate nutritional support and systemic antibiotic therapy should be implemented at once to reduce mortality and insure safe recovery of patients