Acute Colitis Related to Penicillin and Penicillin Derivatives

Toffler, RobertB.; Pingoud, EricG.; Burrell, MortonI.

doi:10.1016/s0140-6736(78)92704-6

Cited by 84 publications

(21 citation statements)

References 9 publications

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“…Diagnosis of AAHC, however, not only relies on endoscopy but foremost on typical clinical history and symptoms and by verifying segmental colitis by performing imaging studies such as sonography or barium enema. In the initial description of AAHC by Toffler et al, 14 most cases were solely diagnosed by barium enema. Previous series in patients with AAC caused by C difficile and in patients with AAHC suggest that sonography is a reliable tool for diagnosing colonic inflammation and its location.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing Klebsiella oxytoca

et al. 2010

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Klebsiella oxytoca was recently described as the causative organism for antibiotic-associated hemorrhagic colitis (AAHC). It is currently not known if this novel gastrointestinal infection exists in children. AAHC is usually preceded by antibiotic treatment with penicillins, which are frequently prescribed for pediatric patients. In contrast to colitis caused by Clostridium difficile, colitis caused by K oxytoca is usually segmental and located predominantly in the right colon. Patients with AAHC typically present with abdominal pain and almost always bloody diarrhea. We present here the case of an adolescent patient who developed acute abdominal pain and bloody diarrhea after antibiotic treatment for acute urinary infection with amoxicillin-clavulanate. Right-sided colitis was verified by abdominal sonography. Stool culture tested negative for common gastrointestinal pathogens but yielded K oxytoca. Toxin production of the isolated strain was verified in a cell-culture assay. Cessation of the causative antibiotic treatment led to rapid improvement and cessation of bloody diarrhea within 3 days. We report here the first (to our knowledge) pediatric case of K oxytoca infection causing AAHC. Establishing the diagnosis of AAHC by culturing K oxytoca and demonstrating right-sided colitis with noninvasive imaging studies might prevent unnecessary invasive procedures in children with bloody diarrhea.

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Section: Discussionmentioning

confidence: 99%

Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing Klebsiella oxytoca

et al. 2010

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“…In a detailed review of the subject, Riley (157) has suggested that the disease was probably first recognized in 1971 (115) in five young adults with a condition referred to as "evanescent colitis." Subsequently, several sporadic cases of the syndrome, going by names such as ischemic colitis and "reversible segmental colitis," were described in the United States (87,148,159), Japan (168,201), and Europe (30, 110,200), although the etiology remained unclear.…”

Section: Hemorrhagic Colitismentioning

confidence: 99%

Infection by verocytotoxin-producing Escherichia coli

1989

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Verocytotoxin (VT)-producing Escherichia coli (VTEC) are a newly recognized group of enteric pathogens which are increasingly being recognized as common causes of diarrhea in some geographic settings. Outbreak studies indicate that most patients with VTEC infection develop mild uncomplicated diarrhea. However, a significant risk of two serious and potentially life-threatening complications, hemorrhagic colitis and the hemolytic uremic syndrome, makes VTEC infection a public health problem of serious concern. The main reservoirs of VTEC appear to be the intestinal tracts of animals, and foods of animal (especially bovine) origin are probably the principal sources for human infection. The term VT refers to a family of subunit exotoxins with high biological activity. Individual VTEC strains elaborate one or both of at least two serologically distinct, bacteriophage-mediated VTs (VT1 and VT2) which are closely related to Shiga toxin and are thus also referred to as Shiga-like toxins. The holotoxins bind to cells, via their B subunits, to a specific receptor which is probably the glycolipid, globotriosyl ceramide (Gb3). Binding is followed by internalization of the A subunit, which, after it is proteolytically nicked and reduced to the A1 fragment, inhibits protein synthesis in mammalian cells by inactivating 60S ribosomal subunits through selective structural modification of 28S ribosomal ribonucleic acid. The mechanism of VTEC diarrhea is still controversial, and the relative roles of locally acting VT and "attaching and effacing adherence" of VTEC to the mucosa have yet to be resolved. There is increasing evidence that hemolytic uremic syndrome and possibly hemorrhagic colitis result from the systemic action of VT on vascular endothelial cells. The role of antitoxic immunity in preventing the systemic complications of VTEC infection is being explored. Antibiotics appear to be contraindicated in the treatment of VTEC infection. The most common VTEC serotype associated with human disease is O157:H7, but over 50 different VT-positive O:H serotypes have now been identified. The best strategies for diagnosing human VTEC infection include testing for the presence of free VT in fecal filtrates and examining fecal cultures for VTEC by means of deoxyribonucleic acid probes that specify genes encoding VT1 and VT2. Both methods are currently confined to specialized laboratories and await commercial development for wider use. In the meantime, most laboratories should continue to screen for the most common human VTEC serotype, O157:H7, using a sorbitol-containing MacConkey medium.

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“…These antibiotics are widely prescribed, and that is why they are associated with PMC more often than other antibiotics. We now know that almost any antibiotic can cause the disease (14,25,32,39,49,55,56,76,80,189,213,231) and that very rarely the disease can even occur without prior antibiotic therapy (63,157,170,239). In addition, treatment with antineoplastic agents which have antibacterial activity can cause the disease (52).…”

Section: Difficile Disease In Humansmentioning

confidence: 99%

Clostridium difficile: its disease and toxins

1988

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Clostridium difficile is the etiologic agent of pseudomembranous colitis, a severe, sometimes fatal disease that occurs in adults undergoing antimicrobial therapy. The disease, ironically, has been most effectively treated with antibiotics, although some of the newer methods of treatment such as the replacement of the bowel flora may prove more beneficial for patients who continue to relapse with pseudomembranous colitis. The organism produces two potent exotoxins designated toxin A and toxin B. Toxin A is an enterotoxin believed to be responsible for the diarrhea and mucosal tissue damage which occur during the disease. Toxin B is an extremely potent cytotoxin, but its role in the disease has not been as well studied. There appears to be a cascade of events which result in the expression of the activity of these toxins, and these events, ranging from the recognition of a trisaccharide receptor by toxin A to the synergistic action of the toxins and their possible dissemination in the body, are discussed in this review. The advantages and disadvantages of the various assays, including tissue culture assay, enzyme immunoassay, and latex agglutination, currently used in the clinical diagnosis of the disease also are discussed.

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Acute Colitis Related to Penicillin and Penicillin Derivatives

Cited by 84 publications

References 9 publications

Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing Klebsiella oxytoca

Antibiotic-Associated Hemorrhagic Colitis Caused by Cytotoxin-Producing Klebsiella oxytoca

Infection by verocytotoxin-producing Escherichia coli

Clostridium difficile: its disease and toxins

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