A case of antibiotic associated pseudomembranous colitis with special reference to allergic reaction to an antibiotic

Abstract

A twenty-six-year old female who had been well and had no serious disease developed pseudomembranous colitis after ampicillin and cloxacillin (Viccillin-S) therapy for acute tonsilitis. Barium enema examination revealed a loss of haustration and a marked narrowing of the colon and colonoscopy showed maculae-like pseudomembrane extensively. A relapse occurred after cessation of metronidazole (Flagyl) and it was successfully treated with Vancomycin. A possible role of allergic reaction to Viccillen S in the case was evaluated. All tests including skin reaction, rectal mucosa reaction and lymphocyte transformation to Viccillin S were negative. Laboratory findings revealed no elevation of eosinophil, IgE or immune complex in the peripheral blood. From these, it was concluded that the case developed pseudomembranous colitis without relation to allergic mechanism with Viccillin S. © 1985, Japan Gastroenterological Endoscopy Society. All rights reserved.