Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment

Abstract

A middle-aged man presented with diarrhea, fever, and leukocytosis 7 days after discontinuation of clindamycin therapy for a urinary tract infection. Proctosigmoidoscopy showed adherent, raised plaques studding the bowel wall consistent with antibiotic-associated pseudomembranous colitis. Vancomycin therapy was begun, but progressive abdominal distension, nausea, vomiting, and loss of bowel sounds occurred. Serial abdominal radiographs demonstrated colonic wall edema without dilatation. Subtotal colectomy was performed and resulted in complete resolution of symptoms.