Pseudomembranous colitis following prophylactic antibiotic use in primary cesarean section

A report of a hospital outbreak of pseudomembranous colitis in three patients given prophylactic antibiotic therapy before and after primary cesarean section is presented. All patients shared the same ward and labor and delivery room, and the colitis occurred within an 8-day period. The diagnosis of pseudomembranous colitis was suspected clinically and confirmed by limited colonoscopy and biopsy followed by stool culture and toxin assay for Clostridium difficile. The high carrier rate of Clostridium difficile in the female urogenital tract and altered colonic motility during pregnancy, in addition to antibiotic use, may have contributed to the establishment of this disease. When diarrhea develops postoperatively in patients who have undergone cesarean section, pseudomembranous colitis as a potential serious complication must be kept in mind and necessary precautions taken to impede cross-contamination and development of secondary cases.