Prevalence of gastrointestinal disease caused by Clostridium difficile in a university hospital in Hungary.

A one-year survey was undertaken to investigate the frequency of diarrhoea caused by Clostridium difficile among patients in a 1200-bed university hospital in Hungary. The VIDAS (bioMérieux) toxin A detection kit was used for screening specimens for the presence of C. difficile toxin. For all other diarrhoeal specimens selected according to special criteria, cytotoxin testing was used to determine the presence of 'free toxin' in the faeces. During the study period, a total of 945 diarrhoeal faecal samples were tested for the presence of C. difficile toxin. Of 375 requested samples, 58 (18.3%) were toxin-A positive. Of the 570 remaining faecal samples selected by the laboratory, 120 (21%) proved to be toxin positive. The results showed that patients from the surgical (33.3%), internal (24%) and haematological (12.8%) wards had the greatest frequency of diarrhoea attributable to C. difficile.

[Ulcerative colitis associated with pyoderma gangrenosum]. / Pyoderma gangrenosummal járó colitis ulcerosa.

The authors present a 42-year-old man's case in whom the onset of chronic ulcerative colitis and pyoderma gangrenosum was simultaneous. Pyoderma gangrenosum began as bullae on his chest and lower limb. The main symptoms were fever, anaemia, hypoproteinaemia beyond the skin lesions, and the abdominal symptoms characterizing chronic ulcerative colitis were absent. The thorough internal check-up and the micribiologic and histologic examinations of the skin disorders made clear that the lesions mentioned were the skin symptoms of a systemic disease. Sulfasalazin and prednisolone therapy of the underlying disease and the local non-specific treatment of the cutaneous lesions resulted together in the patient's rapid improvement. The authors give a brief review of pyoderma gangrenosum and of the connection between pyoderma gangrenosum and chronic ulcerative colitis.