amoxicillin-potassium-clavulanate-combination and Colitis

Four days after beginning a perioperative antibiotic prophylaxis with amoxicillin and clavulanic acid a 33-year-old patient developed an acute haemorrhagic diarrhoea with cramp-like lower abdominal pain. Coloscopy revealed diffuse mucosal oedema with map-like ulcerations, increased susceptibility to trauma and submucous haemorrhages extending from the middle of the ascending to the middle of the descending colon. Granulocytic inflammation with cryptal atrophy was seen histologically. Stool cultures, including tests for Clostridium difficile toxin, were normal. All symptoms disappeared within three days of discontinuing the medication. Coloscopy after one week revealed marked improvement, after three months nothing abnormal. Acute segmental haemorrhagic penicillin-associated colitis is rare and must be distinguished from antibiotic-associated pseudomembranous colitis.

Topics: Abdominal Pain; Acute Disease; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bacterial Proteins; Bacterial Toxins; Clavulanic Acids; Clostridioides difficile; Colitis; Colon; Colonoscopy; Cytotoxins; Diagnosis, Differential; Diarrhea; Drug Therapy, Combination; Feces; Gastrointestinal Hemorrhage; Humans; Male

Topics: Acute Disease; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Colitis; Drug Therapy, Combination; Gastrointestinal Hemorrhage; Humans; Male