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Pseudomembranous colitis complicating ulcerative colitis.
Hideto Kawaratani1, Tatsuhiro Tsujimoto, Masahisa Toyohara
1Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
Summary
Pseudomembranous colitis (PMC) is rare in ulcerative colitis (UC) patients. This case highlights PMC development in a UC patient after antibiotic and corticosteroid treatment, emphasizing the need for prompt diagnosis and management.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Colorectal Surgery
Background:
- Ulcerative colitis (UC) is an inflammatory bowel disease.
- Pseudomembranous colitis (PMC) is typically caused by Clostridium difficile toxin (CD toxin).
- PMC is an uncommon complication in UC patients.
Observation:
- A 71-year-old woman with UC developed PMC after lumbar surgery, postoperative infection, and antibiotic treatment.
- Symptoms included diarrhea, bloody stools, and abdominal pain.
- Colonoscopy confirmed PMC in multiple colonic segments, with positive CD toxin stool tests.
Findings:
- The patient was treated with vancomycin (VCM) while continuing levofloxacin hydrate (LVFX) and prednisolone.
- Symptoms improved, and colonoscopy confirmed PMC resolution.
- Suspected causative agents included cefotiam hydrochloride, LVFX, and prednisolone.
Implications:
- PMC should be considered in UC patients experiencing gastrointestinal symptoms, especially those on antibiotics, immunosuppressants, or corticosteroids.
- Prompt investigation using colonoscopy and CD toxin testing is crucial for early diagnosis and treatment.
- This case underscores the importance of vigilance for PMC in immunocompromised or medically treated UC patients.
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