Pseudomembranous colitis after topical application of clindamycin

Abdominal cramping and diarrhea developed in a 24-year-old woman with facial acne vulgaris five days after she started topical therapy with 1% clindamycin hydrochloride. A stool specimen contained a significant titer of a toxin produced by Clostridium difficile. Findings from sigmoidoscopy and a colonic biopsy specimen were consistent with pseudomembranous colitis. The patient became asymptomatic after ten days of supportive care and oral vancomycin hydrochloride therapy. This case is presented as an example of pseudomembranous colitis associated with topical application of clindamycin.