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Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing
Sun Young Yim1, Ja Seol Koo, Ye Ji Kim
1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Clinical Endoscopy
|June 29, 2012
Summary
Pseudomembranous colitis (PMC) is rare with rifampin, an anti-tuberculosis drug. This case highlights a unique presentation of rifampin-induced PMC sparing the rectum and sigmoid colon, emphasizing the need for thorough investigation during anti-TB therapy.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pulmonology
Background:
- Pseudomembranous colitis (PMC) is typically linked to antibiotic use.
- Antitubercular (anti-TB) agents, particularly rifampin, are infrequently associated with PMC.
- PMC commonly affects the rectum and sigmoid colon, diagnosable via sigmoidoscopy.
Purpose of the Study:
- To report a rare case of rifampin-induced PMC.
- To describe a case with atypical rectosigmoid sparing.
- To raise awareness for early diagnosis in patients on anti-TB treatment.
Main Methods:
- A case report of an 81-year-old male patient with pulmonary tuberculosis.
- Diagnostic evaluation included colonoscopy and biopsy.
- Treatment involved metronidazole and adjustment of anti-TB medications.
Main Results:
- The patient presented with severe diarrhea and weakness during anti-TB treatment.
- Colonoscopy revealed cecal plaques, with non-specific findings in the sigmoid colon.
- Biopsy confirmed PMC, and symptoms improved significantly after treatment modification.
Conclusions:
- Rifampin can induce PMC, even with rectosigmoid sparing.
- Diarrhea during anti-TB therapy warrants consideration of PMC.
- Early total colonoscopy is recommended for suspected cases to ensure timely diagnosis and treatment.
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