Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon

Osler, Turner M.; Lott, Donovan J.; Bordley, John E.; Lynch, Frank P.; Ellsworth, C.; Kozak, Adam

doi:10.1007/bf02555402

Cited by 12 publications

(9 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients who progressed to perforation always had a However, no study demonstrated a superior therapeutic effect of either tapering or pulse dose treatment [1, 21, high mortality rate [7,21,52,76,78,79,179,182,183].…”

Section: Medical Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

Klingler¹,

Metzger²,

Seelig³

et al. 2000

Dig Dis

View full text Add to dashboard Cite

Background:Clostridium difficile has become recognized as a cause of nosocomial infection which may progress to a fulminant disease. Methods: Literature review using electronic literature research back to 1966 utilizing Medline and Current Contents. All publications on antibiotic-associated diarrhea, antibiotic-associated colitis, and pseudomembranous colitis as well as C. difficile infection were included. We addressed established and potential risk factors for C. difficile disease such as an impaired immune system and cost benefits of different diagnostic tests. An algorithm is outlined for diagnosis and both medical and surgical management of mild, moderate and severe C. difficile disease. Results: Diagnosis of C. difficile infection should be suspected in patients with diarrhea, who have received antibiotics within 2 months or whose symptoms started after hospitalization. A stool specimen should be tested for the presence of leukocytes and C. difficile toxins. If this is negative and symptoms persist, stool should be tested with ‘rapid’ enzyme immunoabsorbent and stool cytotoxin assays, which are the most cost-effective tests. Endoscopy and other imaging studies are reserved for severe and rapidly progressive courses. Oral metronidazole or vancomycin are the antibiotics of choice. Surgery is rarely required for selected patients refractory to medical treatment. The threshold for surgery in severe cases with risk factors including an impaired immune system should be low. Conclusion:C. difficile infection has been recognized with increased frequency as a nosocomial infection. Early diagnosis with immunoassays of the stool and prompt medical therapy have a high cure rate. Metronidazole has supplanted oral vancomycin as the drug of first choice for treating C. difficile infections.

show abstract

Section: Medical Treatmentmentioning

confidence: 99%

“…At present the primary surgical strategy is to resect the megacolon, uncontrolled bleeding, and perforation [17,48,76,78,130,[176][177][178][179]. In a 10-year prospective study, damaged bowel and create a protective proximal stoma [7,17].…”

Section: Medical Treatmentmentioning

confidence: 99%

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

Klingler¹,

Metzger²,

Seelig³

et al. 2000

Dig Dis

View full text Add to dashboard Cite

show abstract

“…Treating with oral or intravenous antimicrobial regimens has been shown to be unsuccessful mainly due to inadequate concentration of the drug in the colon [57][58][59]. There is some evidence available that adding intra colonic vancomycin, as an alternative route, can be promising as in 57%-75% of patients [60,[61][62][63][64][65][66][67][68][69][70]. Intravenous metronidazole, in some circumstances, produces fecal concentrations greater than the MIC needed for C. difficile; therefore, it may be an effective therapy [71].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, addition of ICV, administered by rectal enema or long catheters, is an alternative regimen especially in severely ill patients who have not responded to first-line therapy or are not eligible for it [60,[61][62][63][64][65][66][67][68][69][70].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Ahmadi¹,

Rezaee²,

Tanha³

et al. 2016

J Gynecol Res Obstet

View full text Add to dashboard Cite

Journal of Gynecological Research and Obstetrics 055According to the operation report numerous adhesions were detected during surgery, many of which especially those in the uterine incision site had been released. The patient received one dose of prophylactic cefazolin after clamping of the umbilical cord. Before discharge (discharged with personal consent) she had gas passage and defecation.Three days after C/S the patient was hospitalized with a presumed ileus. At that point she seemed well and had no fever and tachycardia; the abdomen was distended; bowel sounds were normal. On palpation, tenderness in left lower quadrant without rebound was present. In chest auscultation no abnormal finding except dextrocardia was detected (Figures 1,2).Initially the patient was managed conservatively, laboratory tests and surgery consult were ordered.The patient was not allowed to take anything by mouth and it was well emphasised to her to stay mobile. Despite gas passage her abdominal distention fluctuated during the first two days of hospitalization. During this period the laboratory findings were normal, no leucocytosis was present and hemoglobin and electrolytes were normal. Just on abdominal x ray( upright and flat) hyperinflation was to be seen.After the second day, diarrhea and a 38 C fever were added to the patients' signs. The diarrhea contained greenish liquid with white cheese -like parts. The patient was not ill, the abdominal palpation revealed no change and the laboratory findings were still normal.On the third day, abdominal distention was noticeably increased and the abdomen became tenser. Emergent surgery and gastrointestinal consult were ordered and the patient was admitted to the intensive care unit. At that point potassium was as low as 2.4 IntroductionPseudomembranous colitis (PMC) is a type of colitis (and sometimes enteritis), with special pathologic and oftentimes radiologic features, which is usually associated with the overgrowth of a bacterium called Clostridium difficile. Although this condition normally occurs following antibiotic consumption, it may rarely happen in other settings such as bowel ischemia, intestinal obstruction, and intestinal surgery or chemotherapy. Moreover, gastrointestinal infections (e.g. Staphylococcus aureus) can induce a similar condition [1].A recent increase in the incidence rate and severity of clostridium difficile infection has been reported, which is thought to be due to the great use of broad spectrum antibiotics worldwide and the development of a hypervirulant strain of this organism [2][3][4]. The presentation of PMC can vary from a self-limiting diarrhea to toxic megacolon and death [5]. Yet, many cases have confusing clinical features and their condition may not be diagnosed immediately [1]. History of previous antibiotic intake especially cephalosporins and flouroquinolones is the most important risk factor for PMC [6][7][8]. This risk is at its peak within the first month after antibiotic use [9].Immediate diagnosis and treatment of this condition can decre...

show abstract

Necrotising colitis with perforation in diarrhoic patients treated with loperamide

Olm

Gonzalez

García‐Valdecasas

et al. 1991

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon

Cited by 12 publications

References 31 publications

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

Pseudomemberanous Colitis following Cesarean Delivery with Adjunctive Intracolonic Vancomycin

Necrotising colitis with perforation in diarrhoic patients treated with loperamide

Contact Info

Product

Resources

About