ABSTRACT
Forty patients, 24 males and 16 females aged 17-65 years, diagnosed clinically, sigmoidoscopically and histopathologically as chronic colitis cases [14 [35%] ulcerative colitis, 4 [10%] Crohn's disease and 22[55%] non specific colitis] were investigated by stool analysis, stool culture and biopsy culture. Chlamydia antigen was detected in biopsy specimens by direct immunofluorescence technique. Ten healthy subjects we included as controls. Hundred percent of cases of inflammatory bowel disease [IBD] were positive for bacterial infections compared to 73% in cases of nonspecific colitis [P<0.05] and infection rate was prominant in bilharzial cases 85%. Salmonella paratyphi [A] and Shigella dysentriae were isolated from both rectal biopsy and stool culture each in 2 cases only. The potentially pathogenic bacteria isolated from biopsy culture only were chlamydia trachomatis, Aeromonas hydrophlla, Pseudomonas aeruginosa, Staph. aureus and Diphtheroid. E. coli were isolated from 40 cases by stool culture and from 14 cases by biopsy culture compared to 4 and 20 cases for Klebsiella sp. In cases that were positive by both biopsy and stool cultures the organisms isolated were identical. There were 4 cases that were diagnosed macroscopically as suspecious ulcerative colitis and microscopically as non specific colitis, while by bacterial cultures each of the following organisms were isolated from one case; Klebsiella sp., E. coli, Chlamydia trachomatis and Pseudomonas aeruginosa. The results of the present work revealed that an appropriate diagnostic program of chronic colitis must include endoscopic, histopathologic and bioptic microbiological examinations in addition to stool culture and analysis to avoid inevitable misdiagnosis of IBD and there is a necessity for the cooperation between the endoscopists, histopathologists and microbiologists to reach a proper diagnosis and proper management