A 78-year-old man who had been diagnosed with ulcerative colitis was admitted because of uncontrolled severe, frequent, bloody diarrhea. He was treated with immunosuppressive therapy that included corticosteroid and azathioprine. Colonoscopy was used to assess disease activity. This revealed that the mucosa of his digestive tract from the rectum to the ileum was damaged. He developed a high-grade fever soon after colonoscopy. Blood culture demonstrated Listeria monocytogenes. Treatment was changed to intravenous ampicillin for 20 days. His general body symptoms, including the bloody diarrhea, improved after treatment. We assume that the colonoscopy induced Listeria monocytogenes septicemia through bacterial translocation in this patient.
2007 by The Japanese Society of Internal Medicine