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[Acute segmental hemorrhagic penicillin-associated colitis]
C Mrowka1, R Münch, M Rezzonico
1Departement für Innere Medizin, Universitätsspital Zürich.
Insights
A rare case of acute hemorrhagic colitis linked to amoxicillin and clavulanic acid resolved after medication cessation. This condition, presenting with severe diarrhea and abdominal pain, differs from antibiotic-associated pseudomembranous colitis.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Antibiotic prophylaxis is common in surgical patients.
- Adverse gastrointestinal effects from antibiotics can occur.
- Distinguishing various forms of colitis is crucial for proper management.
Abstract:
Four days after beginning a perioperative antibiotic prophylaxis with amoxicillin and clavulanic acid a 33-year-old patient developed an acute haemorrhagic diarrhoea with cramp-like lower abdominal pain. Coloscopy revealed diffuse mucosal oedema with map-like ulcerations, increased susceptibility to trauma and submucous haemorrhages extending from the middle of the ascending to the middle of the descending colon. Granulocytic inflammation with cryptal atrophy was seen histologically. Stool cultures, including tests for Clostridium difficile toxin, were normal. All symptoms disappeared within three days of discontinuing the medication. Coloscopy after one week revealed marked improvement, after three months nothing abnormal. Acute segmental haemorrhagic penicillin-associated colitis is rare and must be distinguished from antibiotic-associated pseudomembranous colitis.