Case report demonstrates antibiotic-associated hemorrhagic colitis in a woman, highlighting its recognition is crucial for treatment.
A 50-year-old woman was diagnosed with pelvic peritonitis and treated with amoxicillin/clavulanate (AMPC/CVA). On the sixth day of therapy, she developed abdominal pain, diarrhea, and bloody stools and revisited our hospital. Abdominal computed tomography revealed wall thickening in the right colon. Colonoscopy revealed edematous stenosis with erythema from the ascending to the transverse colon, accompanied by marked mucosal erythema, intramucosal hemorrhage, and adherent mucus. Stool culture revealed Klebsiella oxytoca; however, drug-induced lymphocyte stimulation test for the suspected antibiotic was negative. Antibiotic-associated hemorrhagic colitis (AAHC) was suspected based on the clinical course, medication history, and characteristic endoscopic findings. Her symptoms rapidly improved after discontinuation of antibiotics. AAHC generally has a favorable prognosis once diagnosed. It is important to consider this condition when diagnosing patients with bloody diarrhea receiving antibiotics.
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Kobayashi et al. (2026) studied this question.
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