Faculty mentor/PI email address

jim010@aol.com

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1

Keywords

Stercoral colitis, colitis, vancomycin resistant UTI, enterococcus faecium UTI

Date of Presentation

5-6-2026 12:00 AM

Poster Abstract

We report a case of a 76-year-old female who presented with altered mental status characterized by confusion, decreased verbal interaction, and reduced responsiveness noted by her spouse. The patient had a history of chronic constipation and was brought from home for further evaluation. Initial evaluation raised concern for infection or intracranial hemorrhage as a possible cause of altered mental status. Imaging of the CT brain without contrast was unremarkable, however; abdomen and pelvis revealed a large rectal stool impaction with rectal wall thickening and surrounding perirectal fat stranding consistent with Stercoral Colitis. Urine culture subsequently identified vancomycin-resistant enterococcus faecium. The differential diagnosis for her presentation included metabolic encephalopathy, urinary tract infection–associated delirium, and sepsis; however, imaging findings supported stercoral colitis in the setting of severe fecal impaction. As recognition of stercoral colitis increases, elderly patients with chronic constipation may present with nonspecific symptoms such as altered mental status, highlighting the importance of early identification and prompt management to prevent serious complications including ischemia and colonic perforation.

Disciplines

Digestive System Diseases | Female Urogenital Diseases and Pregnancy Complications | Medicine and Health Sciences

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May 6th, 12:00 AM

Case Report: Vancomycin-Resistant Enterococcus faecium Urinary Tract Infection with Stercoral Colitis Presenting in an Elderly Patient

We report a case of a 76-year-old female who presented with altered mental status characterized by confusion, decreased verbal interaction, and reduced responsiveness noted by her spouse. The patient had a history of chronic constipation and was brought from home for further evaluation. Initial evaluation raised concern for infection or intracranial hemorrhage as a possible cause of altered mental status. Imaging of the CT brain without contrast was unremarkable, however; abdomen and pelvis revealed a large rectal stool impaction with rectal wall thickening and surrounding perirectal fat stranding consistent with Stercoral Colitis. Urine culture subsequently identified vancomycin-resistant enterococcus faecium. The differential diagnosis for her presentation included metabolic encephalopathy, urinary tract infection–associated delirium, and sepsis; however, imaging findings supported stercoral colitis in the setting of severe fecal impaction. As recognition of stercoral colitis increases, elderly patients with chronic constipation may present with nonspecific symptoms such as altered mental status, highlighting the importance of early identification and prompt management to prevent serious complications including ischemia and colonic perforation.

 

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