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[Acute segmental hemorrhagic antibiotic-associated colitis]
C Langner1, D Dorlars, C Gross
1Institut für Pathologie, Klinikum Kassel. cord.langner@kfunigraz.ac.at
Abstract:
Three cases of acute segmental hemorrhagic antibiotic-associated colitis are described occurring in three male adults between 30 and 33 years of age after treatment with oral ampicillin or amoxicillin because of upper respiratory tract infection, tonsillitis, or HLO eradication therapy, respectively. All presented with cramping abdominal pain and bloody diarrhoea of acute onset, however, microbial analysis of fecal samples was negative. Endoscopy showed right-sided segmental hemorrhagic colitis. Histopathological examination demonstrated edema, patchy superficial hemorrhage and a scattered predominantly mononuclear infiltrate of the lamina propria. The surface epithelium was partly desquamated and displayed foci of grouped intraepithelial red blood cells. All patients spontaneously recovered after discontinuation of antimicrobial therapy. The value and limitations of diagnostic features are discussed with respect of the literature.
Insights
Antibiotic-associated colitis can cause acute abdominal pain and bloody diarrhea in adults. Discontinuing ampicillin or amoxicillin led to spontaneous recovery in three male patients.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pathology
Background:
- Antibiotic-associated colitis is a potential complication of antimicrobial therapy.
- Ampicillin and amoxicillin are commonly prescribed antibiotics for various infections.
Observation:
- Three adult males (30-33 years) developed acute symptoms after ampicillin or amoxicillin use.
- Symptoms included cramping abdominal pain and acute onset bloody diarrhea.
- Endoscopy revealed right-sided segmental hemorrhagic colitis.
Findings:
- Histopathology showed edema, superficial hemorrhage, and mononuclear infiltrate.
- Surface epithelium changes included desquamation and intraepithelial red blood cells.
- Microbial analysis of fecal samples was negative for pathogens.
Implications:
- Discontinuation of the causative antibiotic resulted in spontaneous recovery for all patients.
- This highlights the importance of considering antibiotic-induced colitis in differential diagnosis.
- Understanding diagnostic features is crucial for appropriate patient management.