A Case of Rifampicin-Associated Pseudomembranous Colitis / 대한소화기내시경학회지

ABSTRACT

Pseudomembranous colitis is a rare disease and is caused by abnormal overgrowth of toxin producing Clostridium difficile colonizing the large bowel of patients undergoing antibiotic therapy. Rifampicin is one of the first line anti-tuberculous agents, used worldwide. However, pseudomembranous colitis related to rifampicin usage is rare. We report a case of pseudomembranous colitis which developed in a 70-year-old male patient during the first line anti-tuberculous therapy including rifampicin. The patient was diagnosed with active pulmonary tuberculosis thirty days earlier. On admission, he suffered watery diarrhea and intermittent abdominal pain for 10 days. Sigmoidoscopic examination revealed diffusely scattered whitish to yellowish pseudomembrane with skipped areas or edematous hyperemic mucosa from rectum to descending colon, and histopathologic findings were consistent with pseudomembranous colitis with typical volcano-like exudate. Symptoms improved after excluding rifampicin and treatment with metronidazole. In patients with persistent diarrhea and abdominal pain receiving anti-tuberculous therapy including rifampicin, rifampicin-associated pseudomembranous colitis should be considered.