[Toxic megacolon in pseudomembranous colitis. Complicated course of antibiotic-induced Clostridium difficile colitis]

We report on a patient with antibiotic-induced pseudomembranous colitis aggravated by toxic megacolon. Colonoscopy not only rapidly permits the diagnosis to be established, but the relief of pressure achieved simultaneously also has a therapeutic effect. If treatment comprising parenteral fluid and electrolyte replacement in combination with oral vancomycin fails to effect an improvement, surgery becomes necessary. Current recommendations for treatment are discussed on the basis of a review of the literature. However, a major preventive measure remains the rational use of antibiotics.