| Abstract [eng] |
Introduction. Ulcerative colitis is a chronic inflammatory bowel disease characterized by relapses and remissions. In clinical practice, symptoms of ulcerative colitis exacerbation may resemble those cause by intestinal infections. Clostridioides difficile infection and cytomegalovirus colitis are significant in this context. Aim. To describe three clinical case related to intestinal infections caused by Clostridioides difficile and cytomegalovirus, and to review literature on ulcerative colitis and intestinal infections. Methods. Three clinical cases were described, and a literature review was performed using Google Scholar, Pubmed, and UpToDate databases to select 103 articles. Case descriptions. The first two cases present patients with ulcerative colitis diagnosed with Cl. difficile infection. In both cases, the infection was associated with the clinical presentation resembling disease exacerbation. One patient required fecal mictobiota transplantation. The third case describes a patient with cytomegalovirus colitis, which was identified during the exacerbation of ulcerative colitis. He was treated with antiviral treatment. Results. The literature review showed that Cl. difficile infection may imitate or provoke ulcerative colitis flares, while cytomegalovirus colitis is particularly important in severe, prolonged, or treatment-resistant disease. These infections influence treatment strategy, as infectious colitis requires antimicrobial or antiviral therapy, whereas unjustified intesification of immunosupression may worsen the outcomes. Conclusion. When diagnosing flares in patients with ulcerative colitis, possible infectious causes should be assessed. Cytomegalovirus and Cl. difficile infections are an important part of differential diagnosis, and comprehensive evaluation allows accurate identification of symptom causes and appropriate treatment selection. Keywords: ulcerative colitis, inflammatory bowel disease, Clostridioides difficile infection, cytomegalovirus colitis, intestinal infections. |
