A CASE OF ANTIBIOTIC ASSOCIATED PSEUDOMEMBRANOUS COLITIS DUE TO TOXIN PRODUCING CLOSTRIDIUM DIFFICILE, WITH REFERENCE TO ENDOSCOPIC FINDINGS AND ORAL VANCOMYCIN THERAPY

Abstract

In spite of many reports of antibiotic-associated pseudomembranous colitis due to toxin producing Clostridium difficile in Europe and America, we could not find any case reports of this disease in Japan, yet. Recently, we experienced one case of antibiotic-associated pseudomembranous colitis which was first suspected by endoscopic examination, and finally diagnosed by bacteriological studies. This patient was treated by oral Vancomycin therapy and observed by subsequent endoscopy. The patient was 65-year-old woman and she began to complain watery and bloody diarrhea on the 7th day after our appendectomy. Endoscopy was performed and it showed characteristic pseudomembranes with intervening edematous mucosa and bleeding in the entire colon. Clostridium dif f icile was isolated in a count of 10⁶organisms / g of her fresh stool and toxin was positive in 10^-4 dillution by tissue culture assay. She was treated with oral Vancomycin therapy and endoscopic findings showed that pseudomembranes were disappeared on the 2nd day after its administration and normal mucosa was found on the 12th day. Discussion was also made on the diagnosis, treatment and complications of the antibiotic-associated pseudomembranous colitis due to toxin producing Clostridium difficile.