Pseudomembranous Colitis due to Clostridium <I>difficile</I> and the New Therapeutic Approach

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  • KURATSUJI Tadatoshi
    Department of Pediatrics, Keio University School of Medicine Yamato City Hospital
  • YAMADA Kaneo
    Department of Pediatrics, St. Mrianna University School of Medicine
  • OIKAWA Tadao
    Department of Pediatrics, Keio University School of Medicine
  • FUKUMOTO Tetsuo
    Department of Pediatrics, Keio University School of Medicine
  • SHIMIZU Shunichi
    Department of Pediatrics, Keio University School of Medicine
  • IWASAKI Yukio
    Yamato City Hospital
  • TAKIZAWA Kinjiro
    Department of Bacteriology and Pathology, Kanagawa Prefecture Public Health Laboratory
  • ASAI Yoshio
    Department of Bacteriology and Pathology, Kanagawa Prefecture Public Health Laboratory

Bibliographic Information

Other Title
  • <I>Clostridium difficile</I>の分離された偽膜性腸炎の1例とその治療について
  • Clostridium difficileの分離された偽膜性腸炎の1例とその治療について
  • Clostridium difficile ノ ブンリサレタ ギマクセイ チョ
  • Pseudomembranous Colitis due to Clostridium difficile and the New Therapeutic Approach

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Description

A case of pseudomembranous colitis due to Clostridium difficile and the new th erapeutic approach.<BR>A 5 year 7 months old Japanese girl has been in good health untile 5 days before admission when she started to complain of abdominal pain, high fever, vomiting and generalized convulsion. The initial clinical impression was septicemia. She was given ampicillin 100 mg/kg and gentamycin 5 mg/kg. On the 5th hospital day severe colic and watery stools with blo od developed. The leukocytecount was 15, 400/cmm with 90% neutrophiles. The hemoglobin was 10.4 g/dl, serum protain 3.8 g/dl and albumin 1.99 g/dl. Blood and albumin transfusions were performed but the hypoalb uminemia and anemia persisted. The Gordon test was 2.8%. An X-ray film of the abdomen showed thumbprinting, and a scintigram of abdomen ruled out hemorrhagc gastroduodenitis and Meckel's diverticulitis. The proctosigmoidoscopy revealed an edemato us mucosa with white-yellow plaques indicating PMC. Administration of antibiotics was stopped. The plasma FDP was above 40 μg/ml and the thrombocyte count remained 30.5 × 104/cmm. The plasma factor XIII level was 42%, but the plasma plasmin activity, fibrinogen, bleeding time, coagulation time were normal<BR>A total of 1250 units (5 vials) of factor XIII concentrate (Behringwe rke-Hoechst) was administered in 3 days. The abdominal pains subsided and the bowel movement became normal.<BR>Clostridium difficile of over 108/g were found in the stool on the 7th hospital day. Heat labile enterotoxin to the mouse Y-1 adrenal cell was also demonstrated<BR>These results suggests that treatment with factor XIII offers a new possibility of controlling severe hemorrhagic diarrhea in antibiotics-associated PMC.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 54 (9), 518-524, 1980

    The Japanese Association for Infectious Diseases

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