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Antibiotic-associated fulminant pseudomembranous colitis without toxic megacolon
B E Herman1, J Vargo, W S Phillips
1Department of Internal Medicine, National Naval Medical Center, Bethesda, Maryland.
The American Journal of Gastroenterology
|December 1, 1992
Summary
This case study details a severe antibiotic-associated pseudomembranous colitis in a middle-aged male. The patient showed slow recovery with standard treatments, highlighting the challenges of fulminant cases.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Internal Medicine
Background:
- Antibiotic-associated pseudomembranous colitis (AAPC) is a serious complication of broad-spectrum antibiotic use.
- Fulminant cases, though rare, present significant clinical challenges and can lead to severe morbidity.
Observation:
- A middle-aged male presented with fulminant AAPC, exhibiting leukocytosis, hypoalbuminemia, ascites, and anasarca.
- The patient did not develop toxic megacolon, a common complication in severe cases.
- Initial medical therapy included intravenous metronidazole, oral vancomycin, and parenteral nutrition.
Findings:
- The patient demonstrated a slow response to the initial medical regimen.
- Cholestyramine was added to the treatment protocol.
- Literature review on similar fulminant AAPC cases was conducted.
Implications:
- This case underscores the potential for severe presentations of AAPC even without toxic megacolon.
- Slow patient response suggests the need for potentially tailored or aggressive therapeutic strategies in fulminant AAPC.
- Further research into optimal management of severe AAPC is warranted.