Псевдомембранозный колит, осложнённый токсическим мегаколоном, у пациентов онкологического профиля

В последние годы в литературе появляется информация о росте заболеваемости Clostridioides difficile-ассоциированной инфекции (CDI, Clostridioides difficile infection). Известно, что  наиболее часто C.  difficile, вызывающая псевдомембранозный колит (ПМК), поражает ослабленных пациентов, долго получающих лечение основной патологии. Именно поэтому ПМК наиболее часто встречается у пациентов онкологического профиля, получающих длительное и агрессивное противоопухолевое лечение, нередко сопровождающееся применением нескольких курсов антибиотиков. Следствием нерационального применения антибиотиков, некорректной терапии ПМК может быть формирование токсического мегаколона, перфорации кишечника, сепсиса, что в свою очередь чревато летальным исходом. Именно такое положение вещей вызвало наш интерес к изучению данной темы.

Неуклонный рост заболеваемости инфекцией Clostridioides difficile повсеместно делает особенно актуальным изучение проблемы CDI в мировом сообществе применительно к больным онкологического профиля, так как именно у них наиболее часто имеется широкий спектр факторов риска развития клостридиальной инфекции.

В статье представлен обзор отечественных и зарубежных источников описывающих данную патологию. Освещаются эпидемиология, патогенез, клиническая картина и современное представление о лечении CDI.

По окончании обзора нами представлен случай успешного лечения псевдомембранозного колита после закрытия стомы, осложнившегося развитием токсического мегаколона. В рамках комплексного лечения данной патологии была выполнена операция колпроктэктомии. Пациент получал респираторную, почечно-заместительную, гепатопротективную, антибиотико-и противогрибковую терапию и другое лечение.

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