Abstract
We describe the case of a young and otherwise healthy nurse who developed pseudomembranous colitis ten days after receiving oral clindamycin for dental infection. Her clinical course was particularly stormy and was characterized by severe diarrhea and vomiting, profuse ascites, pleural effusion, abdominal tenderness, peritoneal irritation, and systemic toxicity. TheClostridium difficile assay was negative on two occasions. Features compatible with pseudomembranous colitis were seen at sigmoidoscopy, and the diagnosis was confirmed by biopsies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chatila W, Manthous CA.Clostridium difficile causing sepsis and an acute abdomen in critically ill patients. Crit Care Med 1995;23:1146–50.
Lipsett PA, Samantaray DK, Tam ML, Bartlett JG, Lillemoe KD. Pseudomembranous colitis: a surgical disease? Surgery 1994;116:491–6.
McFarland LV, Surawicz CM, Stamm WE. Risk factors forClostridium difficile carriage andC. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 1990;162:678–84.
Kelly CP, Pothoulakis C, LaMont JT.Clostridium difficile colitis. N Engl J Med 1994;330:257–62.
Triadafilopoulos G, Hallstone AE. Acute abdomen as the first presentation of pseudomembranous colitis. Gastroenterology 1991;101:685–91.
Lowenkron SE, Waxner J, Khullar P, Ilowite JS, Niederman MS, Fein AM.Clostridium difficile infection as a cause of severe sepsis. Intensive Care Med 1996;22:990–4.
Nolan NP, Kelly CP, Humphreys JF. An epidemic of pseudomembranous colitis: importance of person-to-person spread. Gut 1987;28:1467–73.
Jobe BA, Grasley A, Deveney KE, Deveney CW, Sheppard BC.Clostridium difficile colitis: an increasing hospital-acquired illness. Am J Surg 1995;169:480–3.
Grundfest-Broniatowski S, Quader M, Alexander F, Walsh RM, Lavery I, Milsom J.Clostridium difficile colitis in the critically ill. Dis Colon Rectum. 1996;39:619–23.
Devenyi AG. Antibiotic-induced colitis. Semin Pediatr Surg 1995;4:215–20.
Biddle WL, Harms JL, Greenberger NJ, Mirer PR Jr. Evaluation of antibiotic-associated diarrhea with a latex agglutination test and cell culture cytotoxicity assay forClostridium difficile. Am J Gastroenterol 1989;84:379–82.
Boland GW, Lee MJ, Cats AM, Ferraro MJ, Matthia AR, Mueller PR.Clostridium difficile colitis: correlation of CT findings with severity of clinical disease. Clin Radiol 1995;50:153–6.
Downey DB, Wilson SR. Pseudomembranous colitis: sonographic features. Radiology 1991;80:61–4.
Boland GW, Lee MJ, Cats AM, Gaa JA, Saini S, Mueller PR. Antibiotic-induced diarrhea: specificity of abdominal CT for the diagnosis ofClostridium difficile disease. Radiology 1994;191:103–6.
Zukerman E, Kanel G, Ha C, Kahn J, Gottesman B, Korula J. Low albumin gradient ascites complicating severe pseudomembranous colitis. Gastroenterology 1997;112:991–4.
Fekety R, Kim KH, Brown D, Batts Dh, Cudmore M, Silva J Jr. Epidemiology of antibiotic-associated colitis: isolation ofClostridium difficile from the hospital environment. Am J Med 1981;70:906–8.
Kaplan N, Davies A, Davies PJ.Clostridium difficile in a healthcare worker [letter]. Hosp Infect 1996;32:322.
Strimling MO, Sacho H, Berkowitz I.Clostridium difficile in healthcare workers. Lancet 1989;2:866–7.
Author information
Authors and Affiliations
About this article
Cite this article
Boaz, A., Dan, M., Charuzi, I. et al. Pseudomembranous colitis. Dis Colon Rectum 43, 264–266 (2000). https://doi.org/10.1007/BF02236993
Issue Date:
DOI: https://doi.org/10.1007/BF02236993