Delayed Onset of Pseudomembranous Colitis After Rifampin Therapy

Rp, Byrd; Tm, Roy; Ma, Ossorio; Cl, Fields

doi:10.1097/00007611-199706000-00013

Cited by 5 publications

(2 citation statements)

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“…3 There have been few reported cases of PMC, however, associated with antituberculosis agents. [4][5][6][7][8][9][10][11][12][13][14] Among such agents, RFP is postulated to be the cause of PMC, because it has an antibiotic effect on a wide range of bacteria, whereas INH and EB have little or no effect on the intestinal flora. 14 Because most Cl.…”

Section: Discussionmentioning

confidence: 99%

Rifampicin-associated pseudomembranous colitis

Nakajima

Yajima

Shirakura

et al. 2000

Journal of Gastroenterology

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We report a case of pseudomembranous colitis that developed in a patient with liver cirrhosis during anti-tuberculosis therapy with rifampicin and isoniazid. The association between rifampicin and pseudomembranous colitis has been controversial; this report, however, supports the association. Colonoscopy performed 3 days after the onset of the pseudomembranous colitis revealed only reddish patches and a few aphthoid lesions, but 4 days later pseudomembranes were apparent. The pseudomembranous colitis was successfully controlled by discontinuation of the anti-tuberculosis agents, along with the administration of lactic acid bacteria, without vancomycin or metronidazole. Possible predisposing factors for the development of pseudomembranous colitis in this patient are also discussed.

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Section: Discussionmentioning

confidence: 99%

Rifampicin-associated pseudomembranous colitis

Nakajima

Yajima

Shirakura

et al. 2000

Journal of Gastroenterology

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“…Most antituberculosis agents have few effects on intestinal flora, so PMC associated with antituberculosis therapy is very rare [7][8][9][10][11][12]. Although few cases of PMC associated with antituberculosis therapy were seen most A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis ficile, tuberculous meningitis, antituberculosis agents, vancomycin…”

Section: Introductionmentioning

confidence: 99%

A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis

Kim¹,

Jeong²,

Choi³

2014

J Biomed Res

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Pseudomembranous colitis (PMC) is known to be associated with the long-term administration of antibiotics, which alter normal gastrointestinal flora and allow overgrowth of Clostridium difficile. However, antituberculosis agents are rarely reported as a cause of this disease. Besides, most cases of antituberculosis agent-induced PMC have been observed in patients with pulmonary tuberculosis but not with tuberculous meningitis. This report presents a case of PMC associated with antituberculosis therapy in a patient with tuberculous meningitis. A 29-year-old female patient was admitted due to headaches and diplopia that had lasted for 2 weeks. She had not recently received antimicrobial therapy. She was diagnosed with tuberculous meningitis by cerebrospinal fluid findings and neurologic examination, including brain imaging study. She was treated with standard antituberculosis agents (HERZ regimen: isoniazid, ethambutol, rifampicin, and pyrazinamide). After 11 days of HERZ, she developed a fever, sudden widespread skin eruption, and elevation of liver enzymes. Considering adverse drug reactions, antituberculosis agents were stopped. One week later, her symptoms were relieved. Thus, antituberculosis agents were reintroduced one at a time after liver function returned to normal. However, she presented with frequent mucoid, jelly-like diarrhea, and lower abdominal pain. Sigmoidscopy revealed multiple yellowish plaques with edematous mucosa, which were compatible with PMC. She was treated with oral vancomycin considering drug interactions. Symptoms were relieved and did not recur when all antituberculosis agents except pyrazinamide were started again. Therefore, when a patient complains of abdominal pain or diarrhea after initiation of antituberculosis therapy, the physician should consider the possibility of antituberculosis agent-associated PMC.

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Clinical Aspects of Rifampicin-associated Pseudomembranous Colitis

Jung¹,

Jeon²,

Do³

et al. 2007

Journal of Clinical Gastroenterology

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Pseudomembranous colitis (PMC) is known to develop after antibiotic administration, but antituberculosis agents are rarely associated with this disorder. We report 6 cases of PMC after rifampicin administration; the clinical manifestations, laboratory findings, imaging findings, and clinical course are described. The median age of patients was 68 years (range, 54 to 82 y). All patients were diagnosed with active pulmonary tuberculosis by sputum smear and culture, and 2 suffered from type 2 diabetes mellitus. The average interval between initiation of antituberculosis therapy and the onset of diarrhea was 19.8 days. The anatomic distribution of PMC included the rectum and sigmoid colon in 5 cases and up to the hepatic flexure in 1 case. All patients were cured with medical treatment, which include discontinuation of rifampicin and oral metronidazole and vancomycin. PMC recurred in 1 patient after retreatment with rifampicin. Our findings suggest that patients who are treated with antituberculosis agents, who develop acute diarrhea during or after therapy, should be evaluated for PMC.

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Delayed Onset of Pseudomembranous Colitis After Rifampin Therapy

Cited by 5 publications

References 0 publications

Rifampicin-associated pseudomembranous colitis

Rifampicin-associated pseudomembranous colitis

A case of pseudomembranous colitis associated with antituberculosis therapy in a patient with tuberculous meningitis

Clinical Aspects of Rifampicin-associated Pseudomembranous Colitis

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