Toxic Megacolon After Irrational Antibiotic Treatment of Pregnant Patient With Covid 19: Case Report

ABSTRACT

Introduction: Optimal management of toxic megacolon as a consequence of Cl. difficile colitis is still matter of controversy, as well as timing of available therapeutic modalities. In this article we report a case of severe C. difficile colitis associated with toxic megacolon in a pregnant patient with Covid 19, who was successfully treated conservatively. Case Report A 33-years old pregnant woman contracted SARS-CoV-2 in the 32nd week of pregnancy. She was admitted to regional hospital and treated extensively by wide-spectrum antibiotics. After the delivery she developed severe form of Cl. difficile colitis with toxic megacolon. In spite of severe clinical picture, the patient was treated conservatively, with high initial oral doses of vancomycin, with subsequent tapering. The outcome of the treatment was complete recovery and colonic functions were regained completely. Conclusion: In conclusion, our case shows that in younger patients, who were fit before occurrence of Cl. difficile colitis and toxic megacolon, conservative therapy should be tried as long as possible before turning to colectomy, since chances for cure without surgery are considerable. (English) [ FROM AUTHOR] Uvod Optimalno upravljanje toksičnim megakolonom kao posledicom Cl. difficile kolitis je još uvek predmet kontroverzi, kao i vreme kada su dostupni terapijski modaliteti. U ovom članku izveštavamo o slučaju teškog kolitisa C. difficile povezanog sa toksičnim megakolonom kod trudnice sa Covid-om 19, koja je uspešno lečena konzervativno. Prikaz slučaja Trudnica stara 33 godine zarazila se SARS-CoV-2 u 32. nedelji trudnoće. Primljena je u regionalnu bolnicu i intenzivno lečena antibioticima širokog spektra. Nakon porođaja razvila je teški oblik Cl. difficile kolitis sa toksičnim megakolonom. I pored teške kliničke slike, pacijent je lečen konzervativno, visokim početnim oralnim dozama vankomicina, uz naknadno smanjivanje. Ishod lečenja je bio potpuni oporavak i potpuno su vraćene funkcije debelog creva. Zaključak U zaključku, naš slučaj pokazuje da kod mlađih pacijenata, koji su bili u formi pre pojave Cl. difficile kolitisa i toksičnog megakolona, konzervativnu terapiju treba pokušavati što je duže moguće pre nego što se pređe na kolektomiju, pošto su šanse za izlečenje bez operacije znatne. (Bosnian) [ FROM AUTHOR] Copyright of Hospital Pharmacology International Multidisciplinary Journal is the property of Serbian Medical Society, Section for Clinical Pharmacology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)