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A case of severe pseudomembranous colitis diagnosed by colonoscopy after Helicobacter pylori eradication

Abstract

A 65-year-old male was admitted for hemorrhagic gastric ulcer. Since anti-Helicobacter pylori-immunoglobulin G antibody tested positive, eradication therapy was administered using rabeprazole, amoxicillin, and clarithromycin. During hospitalization, colonoscopy showed normal colonic mucosa except for a polyp of the sigmoid colon. He was discharged 4 days after finishing eradication therapy, but fever up and diarrhea appeared on the following day. After re-admission, colonoscopy revealed multiple yellowish-white, small circular membranous elevations, and a diagnosis of pseudomembranous colitis was made. He was successfully treated by oral administration of vancomycin. Concomitant use of antibiotics and a proton pump inhibitor for a hospitalized patient is a risk for pseudomembranous colitis. However, H. pylori eradication therapy should be started at re-introduction of oral feeding in cases of bleeding ulcers because rebleeding can be mortal in patients in ‘poor general condition’. Physicians should consider pseudomembranous colitis as a diagnosis for the patients with diarrhea and high fever following H. pylori eradication therapy.

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Disclosure

Conflict of Interest: Satoshi Sato, Daisuke Chinda, Kiyonori Yamai, Ryu Satake, Yasushi Soma, Tadashi Shimoyama, and Shinsaku Fukuda declare that they have no conflict of interest.

Human/Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent: Informed consent was obtained from all patients for being included in the study.

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Correspondence to Tadashi Shimoyama.

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Sato, S., Chinda, D., Yamai, K. et al. A case of severe pseudomembranous colitis diagnosed by colonoscopy after Helicobacter pylori eradication. Clin J Gastroenterol 7, 247–250 (2014). https://doi.org/10.1007/s12328-014-0490-6

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  • DOI: https://doi.org/10.1007/s12328-014-0490-6

Keywords

  • Helicobacter pylori
  • Eradication
  • Pseudomembranous colitis