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Pseudomembranous colitis associated with antibiotic therapy - an emerging entity.
Canadian Medical Association Journal
|November 16, 1974
Summary
Antibiotic-associated pseudomembranous colitis can be severe, but prompt diagnosis and treatment, including surgery or fecal enemas, lead to recovery. This highlights antibiotics as key causes and the importance of diagnostic findings.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Internal Medicine
Background:
- Pseudomembranous colitis is a serious gastrointestinal condition.
- Antibiotics are frequently implicated as the primary cause.
- Early recognition of symptoms and diagnostic signs is crucial.
Purpose of the Study:
- To present two distinct cases of pseudomembranous colitis.
- To emphasize the role of specific antibiotics in its etiology.
- To highlight diagnostic methods and treatment outcomes.
Main Methods:
- Case report of two patients with pseudomembranous colitis.
- Review of antibiotic history (novobiocin-tetracycline, penicillin, clindamycin).
- Description of clinical presentation, diagnostic findings (sigmoidoscopy, histology), and treatment interventions (ACTH, colectomy, fecal enema, Lactobacillus).
Main Results:
- Patient 1: Developed severe diarrhea post-antibiotics, unresponsive to ACTH, recovered after subtotal colectomy.
- Patient 2: Developed severe diarrhea post-clindamycin, recovered with ACTH, Lactobacillus, and fecal enema.
- Both cases underscore the link between antibiotic use and pseudomembranous colitis.
Conclusions:
- Antibiotics are significant etiological agents in pseudomembranous colitis.
- Classic sigmoidoscopic and histologic findings are key for rapid diagnosis.
- Diverse treatment strategies, including surgical intervention and fecal microbiota transplantation, can lead to recovery.