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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
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β-lactam-associated eosinophilic colitis.

Tamara Mogilevski1, David Nickless2, Sam Hume3

  • 1Department of Medicine, The Northern Hospital, Epping, Victoria, Australia.

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Summary

A man developed eosinophilic colitis after taking cephalexin and amoxicillin. His symptoms resolved without specific treatment, suggesting a link between beta-lactam antibiotics and this rare condition.

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Pharmacology

Background:

  • Eosinophilic colitis is a rare, heterogeneous gastrointestinal disorder.
  • It can be triggered by helminthic infections, drug reactions, or associated with ulcerative colitis.

Observation:

  • A 42-year-old male with asthma history presented with watery diarrhea and peripheral eosinophilia after cephalexin use.
  • Colonoscopy showed patchy colitis, with biopsies confirming eosinophilic colitis.
  • Amoxicillin administration two months later caused recurrence of peripheral eosinophilia.

Findings:

  • The patient was diagnosed with beta-lactam-associated eosinophilic colitis due to symptom onset following antibiotic administration.
  • Symptoms and peripheral eosinophil counts improved spontaneously without specific intervention.
  • This case highlights a potential adverse drug reaction to beta-lactam antibiotics.

Implications:

  • Beta-lactam antibiotics can induce eosinophilic colitis, a condition typically managed with corticosteroids if secondary causes are ruled out.
  • Further research into the pathogenesis of drug-induced eosinophilic colitis is warranted.
  • Clinicians should consider antibiotic-induced eosinophilic colitis in patients presenting with relevant symptoms and eosinophilia.