Korean J Gastroenterol.  2009 Jan;53(1):53-56.

A Case of Pseudomembranous Colitis Associated with Rifampicin Therapy in a Patient with Rectal Cancer and Gastrointestinal Tuberculosis

• Choi YJ
• Kim HG
• Choi YA
• Joo WC
• Son DW
• Kim CH
• Shin YW
• Kim YS

Abstract

Pseudomembranous colitis (PMC) is known to be associated with the administration of antibiotics which alter normal gastrointestinal flora and allow overgrowth of Clostridium difficile. Most cases of rifampicin-induced PMC are seen in patients with pulmonary tuberculosis, but not with gastrointestinal tuberculosis. We report a case of PMC associated with rifampicin therapy in a patient with gastrointestinal tuberculosis. A 65-year-old female patient with rectal cancer and gastrointestinal tuberculosis was admitted due to abdominal pain and diarrhea. She was treated with anti-tuberculosis agents containing rifampicin. On colonoscopic examination, mucoid exudates and yellowish plaque lesions were observed. Anti-tuberculosis agents were stopped, and the patient was treated with metronidazole. Symptoms were relieved and did not recur when all the anti-tuberculosis agents except rifampicin were started again. When a patient complains of abdominal pain or diarrhea while taking rifampicin, the physician should consider the possibility of rifampicin-associated PMC.

Keyword

Gastrointestinal tuberculosis; Rectal cancer; Rifampicin; Pseudomembranous colitis

MeSH Terms

Aged
Antibiotics, Antitubercular/*adverse effects/therapeutic use
Enterocolitis, Pseudomembranous/*diagnosis/etiology/pathology
Female
Humans
Rectal Neoplasms/*complications/diagnosis
Rifampin/*adverse effects/therapeutic use
Sigmoidoscopy
Tuberculosis, Gastrointestinal/complications/diagnosis/*drug therapy