A Case of Acute Hemorrhagic Colitis Requiring Differentiation from Ulcerative Colitis

• Published in: Japanese Journal of National Medical Services Vol. 43; no. 12; pp. 1345 - 1347
• Main Authors: OBATA, Shinichiro, MAEDA, Kazuhiro, KIMURA, Keishi, SATO, Masahiko, SANADA, Isao, MATSUMURA, Katsumi, HIGASHI, Kiichiro, SHIDO, Tadahiro, MIURA, Kazunori
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1989
• Subjects: Klebsiella oxytoca
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.43.1345

Antibiotics associated-colitis is the disease paid new attention due to the high frequency of using antibiotics. Acute hemorrhagic colitis (AHC) is important among the antibiotics associated-colitis because of acute onset and severity of bleeding. AHC is mainly caused by administration of penicillins such as aminobenzyl penicillin (ABPC), especially by enteral route. To the best of our knowledge, there is no report of AHC due to Sulbactum/Cefoperazone (S/C). Therefore, we report the first case of a 44-year-old patient with AHC after intravenous administration of S/C, who complained of abdominal pain, diarrhea and melena. The sigmoidoscopy showed redness, erosion and hemorrhage at the rectum that appeared unusual for ACH. It was necessary to differentiate AHC from ulcerative colitis. Klebsiella oxytoca which was resistant with ABPC, was detected in the stool culture but Clostridivm difficile and its toxins were not detected. Inspite of many reports suggesting relationship between AHC and Clostridivm difficile and its toxins, Klebsiella oxytoca might have caused AHC in our case as in Totani's report.