A case of pseudomembranous esophagitis developing after azithromaycin intake

Abstract

We report the case of a woman in her seventies who had diabetes mellitus and hemodialysis with chronic renal failure. She was treated for acute bronchitis with azithromycin for 3 days after 1 week, she had dysphagia and was referred to our hospital for further examination. Esophagogastroduodenoscopy revealed redness, erosion and multiple elevated yellow-white plaques and stenosis of the lower esophagus. Histopathologic findings included granulation tissue formation, fibrinous exudate, and infiltration consisting mainly of neutrophils with pseudomembrane. She was treated with vonoprazan fumarate, after 7 weeks, the pseudomembranous esophagitis improved endoscopically. After 1 and 8 months, the anterior chest wall was distended. MRI revealed arthritis of the sternocostal joint and abscess formation in the chest wall. The abscess ruptured in its natural course, and then improved. The patient continues to be monitored.