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Clostridium difficile infection associated with antituberculous agents in a patient with tuberculous pericarditis

Yi-Xuan Sun1, Yin-Tao Zhao, Li-Li Teng

  • 1Department of Geriatric Medicine, East Hospital, Tongji University School of Medicine, China.

Internal Medicine (Tokyo, Japan)
|July 2, 2013
PubMed

Insights

Antituberculous therapy can lead to pseudomembranous colitis (PMC), a condition typically linked to other antimicrobials. This case highlights a patient whose PMC resolved upon stopping anti-TB drugs and recurred upon restarting them.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Pharmacology

Background:

  • Clostridium difficile infection (CDI) commonly causes pseudomembranous colitis (PMC).
  • Antimicrobial exposure is a known risk factor for CDI.
  • Antituberculous (anti-TB) agents are generally not considered a risk factor for CDI.

Observation:

  • A 63-year-old woman with tuberculous pericarditis developed abdominal pain and diarrhea during anti-TB therapy.
  • Colonoscopy revealed characteristic findings of PMC, including mucoid exudate and yellowish plaques.
  • Discontinuation of anti-TB agents led to symptom resolution.

Findings:

  • The patient's PMC resolved after stopping anti-TB medication.
  • Symptoms recurred upon reinitiation of anti-TB therapy, suggesting a causal link.
  • Treatment with metronidazole and Clostridium butyricum was effective.

Implications:

  • This case suggests a potential association between anti-TB therapy and PMC.
  • Further research is warranted to explore the pathogenesis of anti-TB-associated CDI.
  • Clinicians should consider CDI in patients on anti-TB treatment presenting with gastrointestinal symptoms.

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