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Clostridium difficile colitis associated with the use of antineoplastic agents
European Journal of Clinical Microbiology
|February 1, 1984
Summary
Chemotherapy, particularly methotrexate, can cause Clostridium difficile-related diarrhea and colitis. Prompt diagnosis and treatment with oral vancomycin are crucial for managing this serious complication in cancer patients.
Area of Science:
- Gastroenterology
- Oncology
- Infectious Diseases
Background:
- Antineoplastic agents, including folic acid antagonists like methotrexate, are used in cancer treatment.
- Clostridium difficile infection (CDI) is a known cause of antibiotic-associated diarrhea and colitis.
- The link between chemotherapy and CDI is increasingly recognized.
Purpose of the Study:
- To report on a series of patients who developed Clostridium difficile-related diarrhea and pseudomembranous colitis during or after antineoplastic chemotherapy.
- To highlight the clinical similarities between chemotherapy-induced and antibiotic-associated CDI.
- To emphasize the importance of suspecting CDI in patients undergoing chemotherapy.
Main Methods:
- Case series presentation of eight patients.
- Clinical data collection on patient presentation, chemotherapy regimens, and treatment outcomes.
- Comparison of clinical presentation with established cases of antibiotic-associated CDI.
Main Results:
- All eight patients developed Clostridium difficile-related diarrhea and pseudomembranous colitis.
- The clinical presentation was indistinguishable from antibiotic-associated diarrhea and colitis.
- Treatment with oral vancomycin was effective in resolving the symptoms.
Conclusions:
- Chemotherapy, especially with methotrexate, can precipitate Clostridium difficile-related diarrhea and colitis.
- Clinicians should suspect CDI in patients with diarrhea during or shortly after antineoplastic chemotherapy.
- Oral vancomycin is an effective treatment for this complication.