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Antibiotic-associated colitis with normal-appearing rectum

E J Burbige, J J Radigan

    Diseases of the Colon and Rectum
    |April 1, 1981
    PubMed
    Summary
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    Pseudomembranous colitis can occur even with normal lower endoscopy results. Prompt fiberoptic colonoscopy is crucial for diagnosing severe cases of this antibiotic-associated condition.

    Area of Science:

    • Gastroenterology
    • Infectious Diseases
    • Colorectal Surgery

    Background:

    • Antibiotic administration, particularly for surgical prophylaxis, can predispose patients to Clostridioides difficile infection.
    • Pseudomembranous colitis is a severe form of this infection, characterized by inflammatory pseudomembranes in the colon.

    Observation:

    • A patient presented with severe pseudomembranous colitis affecting the proximal colon.
    • The rectum and distal sigmoid appeared normal during examination.
    • Symptoms arose three weeks post-prophylactic antibiotic administration.

    Findings:

    • Discontinuation of antibiotics led to clinical improvement in the patient.
    • Standard sigmoidoscopy may not detect proximal colonic pathology in pseudomembranous colitis.

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    Implications:

    • Fiberoptic colonoscopy is recommended for diagnosing suspected pseudomembranous colitis, especially when sigmoidoscopy is inconclusive.
    • Early diagnosis and management, including antibiotic cessation, are vital for patient recovery.
    • This case highlights the importance of considering C. difficile infection in patients with gastrointestinal symptoms after antibiotic exposure.