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[Pseudomembranous colitis after Helicobacter pylori eradication therapy]
Norihiko Kubo1, Shuji Kochi, Iwao Ariyama
1Department of General Medicine, Kyushu University Hospital.
Summary
Helicobacter pylori eradication therapy can lead to serious Clostridium difficile infection and pseudomembranous colitis. Careful monitoring is essential to prevent this complication during H. pylori treatment.
Area of Science:
- Gastroenterology
- Infectious Diseases
Background:
- A 69-year-old woman underwent triple regimen therapy for Helicobacter pylori (H. pylori) eradication.
- The regimen included Amoxicillin, Clarithromycin, and Lansoprazole.
Observation:
- Twenty days post-therapy, the patient developed severe watery diarrhea.
- Colonoscopy revealed pseudomembranes, diagnosing pseudomembranous colitis.
- A positive Clostridium difficile (CD) toxin stool test confirmed the infection.
Findings:
- The patient experienced a relapse of diarrhea due to inadequate Vancomycin (VCM) dosage.
- Treatment with high-dose oral VCM resolved the CD infection and colitis symptoms.
- The case highlights a potential link between H. pylori eradication and C. difficile-associated colitis.
Implications:
- Clinicians must be vigilant for pseudomembranous colitis in patients undergoing H. pylori eradication.
- Ensuring adherence and appropriate dosing of antibiotics, including VCM for C. difficile, is critical.
- This case underscores the importance of considering antibiotic-induced complications during H. pylori treatment.