Fulminant Pseudomembranous Colitis In Multi-Organ Dysfunction Syndrome Patient

Khalid Ibrahim, Mannan Masud, Waqas Ahmed, Bushra Aman, Rabia Mushtaq

Abstract

Pseudo membranous colitis also called Clostridium difficle colitis is the inflammation of colon associated with overgrowth of Clostridium difficle due to overuse of antibiotics. We report a case of fulminant pseudo membranous colitis, in a 26 year old female who was referred from other hospital with history of pain epigastrium, vomiting, and fever for the last ten days. She remained admitted there for five days and received injectable cefrtiaxone, tazocin, diclofenac, and anti-malarial drugs. Her symptoms aggravated along with black colored loose motions. She had past history of using omeprazole off and on. In ER on arrival she complained of abdominal pain, distension with irritability and blood mixed stool. X-ray abdomen showed free air. On abdominal tap fecal matter was found. Emergency laparotomy was done which revealed huge cecal, hepatic flexure, mid transverse colon, splenic flexure and mid left colon perforations with multiple ulcers. Distal ileostomy along with mucous fistula, after subtotal colectomy was performed. Patient was managed postoperatively in ICU and on ventilator support and showed gradual recovery.

 Key words

Pseudo membranous colitis, Clostridium difficle, Fulminant colitis, Rational use of drugs.