Acute Self-limited Colitis
Definition
- Inflammation of the colon due to infectious organisms, generally short term
Diagnostic Criteria
- Predominantly acute inflammation largely restricted to lamina propria
- Neutrophilic involvement of crypt epithelium may be seen
- Crypt abscesses may be seen
- May be patchy or diffuse
- Lacks chronic changes of inflammatory bowel disease
- Minimal to no crypt distortion or drop out
- Mild to no chronic inflammatory infiltrate in lamina propria
- Persistent and severe infections may lead to mild crypt distortion
- Severe cases may lead to ulceration, hemorrhage and microthrombi
- Common causes include:
- Campylobacter jejunalis
- May have prominent macrophage infiltrate
- Salmonella
- Lacks mucus depletion except in severe cases
- May have prominent macrophage infiltrate with erythrophagocytosis
- Shigella
- Mucus depletion
- Aphthous ulcers over lymphoid follicles
- Severe cases may ulcerate with a pseudomembrane
- Yersinia
- May have aphthous ulcers
- May have necrotic granulomas
- May have prominent follicular hyperplasia
- About half of cases have no identifiable bacterial cause
- Many such cases are viral
- Stool ova and parasite examination is necessary to rule out parasitic cause
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : November 11, 2009
