Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin's lymphoma

作     者：Kenichi Nomura Yosuke Matsumoto Naohisa Yoshida Sawako Taji Naoki Wakabayashi Shoji Mitsufuji Shigeo Horiike Masuji Morita Takeshi Okanoue Masafumi Taniwaki 

作者机构：Molecular Hematology and OncologyKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Molecular Gastroenterology and HepatologyKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan School of NursingKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Clinical Molecular Genetics and Laboratory MedicineKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2004年第10卷第5期

页      面：765-766页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：暴发性抗生素相关性大肠炎 利福平 非何杰金氏淋巴瘤 抗药性羧形菌 病例报告 

摘      要：A 74-year-old man was admitted to the hospital because of chemotherapy for relapsed non-Hodgkin s lymphoma (NHL).The patient became febrile and experienced diarrhea after chemotherapy. Although ceftazidime and amikacin sulfate were administered as empiric therapy, diarrhea was *** several days, stool cytotoxin assay for clostridium difficile (C. difficile) was positive and he was diagnosed as having antibiotics-associated colitis (AAC). Although antibiotics were discontinued and both oral vancomycin and metronidazole were administrated, disease was not improved. To rule out the presence of an additional cause of diarrhea, colon fiberoscopic examination was performed. It revealed multiple deep ulcerative lesions at right side colon, surface erosive and minute erosive lesions in all continuous *** were not seen. These findings are compatible with AAC without pseudomembranes. There are no reports that the rifampin is effective on refractory ***, we administered oral rifampin for the current *** reasons are 1) conventional antibiotics were not effective,2) rifampin has excellent in vitro activity against C. difficile,and 3) the efficacy of rifampin on relapsing colitis due to *** is established. After administration of rifampin, fever alleviated and diarrhea was improved. Because AAC may result in significant mortality, patients with refractory or fulminant AAC should be treated with oral rifampin from outset.