Surgical Pathology Criteria

Enterohemorrhagic E coli Colitis

Differential Diagnosis

  • Colitis due to E coli O157:H7 may be histologically indistinguishable from acute ischemia
    • Ischemia is usually localized
    • Clinical correlation and culture is necessary
    Acute Self-limited Colitis Enterohemorrhagic E coli Colitis
    Necrosis not typically seen Superficial mucosal necrosis
    Hemorrhage and thrombosis not typically seen Frequent hemorrhage and capillary thrombosis

    Pseudomembranous Colitis Enterohemorrhagic E coli Colitis
    Endoscopic pseudomembrane Pseudomembrane only microscopic
    Necrotic crypt epithelium erupts into lumen to form pseudomembrane Entire upper mucosal layer may slough into lumen to form pseudomembrane
    Hemorrhage is not prominent Prominent hemorrhage and capillary thrombosis
    C difficile titers elevated E coli O157:H7 identified by culture
    Associated with antibiotic therapy Not associated with antibiotic therapy

  • Stanford Medicine Resources:

    Footer Links: