Perforation Complicating Rifampin-Associated Pseudomembranous Enteritis

An 18-year-old man developed a perforated jejunum while receiving rifampin antituberculous chemotherapy. The perforations were located within longitudinal ulcers characteristic of pseudomembranous enterocolitis. Pseudomembranous inflammation was limited to the small intestine. The absence of colonic involvement delayed establishment of the diagnosis. Successful surgical intervention consisting of small-bowel resection with primary anastomosis was accomplished for this rare and potentially fatal complication of antituberculous chemotherapy.