ABSTRACT

Biopsy in intestinal infection may occasionally result in the direct identification of an organism or, more usually, permit a presumptive diagnosis from the pattern of inflammation (e.g. tuberculosis in the presence of caseating granulomas). Perhaps the commonest biopsy dilemma in routine practice is to distinguish infective colitis from the first attack

of chronic inflammatory bowel disease (CIBD), that is Crohn’s disease or ulcerative colitis (Section 4.2.5). In North America the former is generally referred to as acute self-limiting colitis (ASLC). The standard classifica.tion of infective colitis is aetiological, namely viral, bacterial, protozoal, fungal infections and infestations by helminths. In Western countries it is the bacterial diarrhoeas which form the large majority of the diagnostic problems.