Neurological patients are at increased risk of gastrointestinal bleeding or perforation. In one cohort of non-trauma neurosurgical ICU patients, 6.8% had endoscopically or surgically documented evidence of post-operative GI complications. The majority had bleeding, but two patients had both bleeding and perforation. Multivariate analysis suggested five risk factors of independent significance: (1) the presence of SIADH, (2) pre-operative coma, (3) the presence of post-operative complications, (4) age over 60 years, and (5) pyogenic infection of the CNS. Pre-operative coma was the only significant factor to predict the occurrence of life-threatening GI complications. Thus prophylaxis with a proton pump inhibitor or H2 antagonists is routinely indicated in these patients.
Patients on broad-spectrum antibiotics may also develop pseudomembranous colitis, which usually subsides with discontinuation of antibiotic therapy.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.