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Pseudomembranous enterocolitis. Resurgence related to newer antibiotic therapy
Abstract:
Six patients with pseudomembranous entercolitis were seen at one institution over a six-month period. Clindamycin therapy preceded the diagnosis in all six patients and possibly caused the disease in five cases. Common clinical features included diarrhea, abdominal pain, fever, leukocytosis, radiographic findings of large bowel dilatation with mucosal thickening and a characteristic sigmoidoscopic or gross pathologic demonstration of discrete yellow-white plaques on an otherwise normal mucosa. Complications included toxic megacolon and sigmoid colon perforation. Two of the six patients died. The literature since 1970 is tabulated to clarify the clinical and pathological features of pseudomembranous enterocolitis associated with newer antibiotic therapy. Lincomycin and clindamycin are strongly implicated in the recent resurgence of this formerly rare variety of colitis.
Insights
Clindamycin use can lead to pseudomembranous enterocolitis, a severe bowel condition. This study highlights its association with clindamycin and lincomycin antibiotics.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Pseudomembranous enterocolitis is a severe gastrointestinal condition.
- Antibiotic therapy, particularly with clindamycin and lincomycin, has been associated with this condition.
- Recent resurgence necessitates a review of clinical and pathological features.
Purpose of the Study:
- To report on six cases of pseudomembranous enterocolitis.
- To identify clinical and pathological features of the disease.
- To review the literature since 1970 regarding antibiotic-associated colitis.
Main Methods:
- Case series of six patients diagnosed with pseudomembranous enterocolitis.
- Clinical data collection including symptoms, physical examination, and laboratory findings.
- Review and tabulation of relevant literature published after 1970.
Main Results:
- Clindamycin therapy preceded diagnosis in all six patients; five cases possibly caused by clindamycin.
- Common symptoms included diarrhea, abdominal pain, fever, and leukocytosis.
- Radiographic and endoscopic findings revealed large bowel dilatation, mucosal thickening, and characteristic plaques.
Conclusions:
- Clindamycin and lincomycin are strongly implicated in the resurgence of pseudomembranous enterocolitis.
- The disease presents with distinct clinical and pathological features.
- Prompt recognition and management are crucial due to potential complications like toxic megacolon and perforation.