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Antibiotic-associated hemorrhagic colitis
1Yale University School of Medicine, New Haven, Connecticut.
Abstract:
Antibiotic-associated hemorrhagic colitis is an infrequently recognized, self-limited process that may be experienced by patients receiving oral penicillin derivatives, primarily for upper respiratory infections. Symptoms of diarrhea, abdominal tenderness, and ultimately bloody diarrhea occur within one week of antibiotic use. Resolution of symptoms typically occurs within three days of discontinuing the offending antibiotic. Previous reports have suggested a non-inflammatory process involving the right colon. We present four cases and review the literature with respect to presentation, diagnosis, course, and postulated pathophysiologic mechanisms. Our patients demonstrate a more heterogeneous population than previously noted. This disease can affect young and old, male and female, and can involve the entire colon. Active inflammation demonstrated by fecal leukocytes, peripheral leukocytosis, and an active inflammatory infiltrate on biopsy are reported.
Insights
Antibiotic-associated hemorrhagic colitis, a rare condition from oral penicillin use, causes bloody diarrhea. Symptoms resolve within days of stopping the antibiotic, and inflammation can affect the entire colon.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Antibiotic-associated hemorrhagic colitis (AAHC) is a rare, self-limited gastrointestinal condition.
- It is typically associated with oral penicillin derivatives used for upper respiratory infections.
Observation:
- Patients present with diarrhea, abdominal tenderness, and bloody diarrhea within a week of antibiotic initiation.
- Previous literature suggested a non-inflammatory process primarily affecting the right colon.
Findings:
- This study presents four cases, highlighting a more heterogeneous patient population than previously described.
- The condition can affect individuals of all ages and genders and may involve the entire colon.
- Evidence of active inflammation, including fecal leukocytes, peripheral leukocytosis, and inflammatory infiltrates on biopsy, was observed.
Implications:
- The findings expand the understanding of AAHC presentation and pathophysiology.
- Recognizing AAHC is crucial for timely diagnosis and management, leading to prompt symptom resolution.
- Further research into the mechanisms of AAHC may inform preventative strategies.