Korean J Gastrointest Endosc.  2005 Jun;30(6):330-335.

A Case of Rifampicin-Associated Pseudomembranous Colitis

• Kim HK
• Kim JW
• Shin OR
• Cho YS
• Son SH
• Kim SS
• Chae HS
• Kim KH
• Choi KY
• Chung IS

Abstract

Pseudomembranous colitis is a rare disease and is caused by abnormal overgrowth of toxin producing Clostridium difficile colonizing the large bowel of patients undergoing antibiotic therapy. Rifampicin is one of the first line anti-tuberculous agents, used worldwide. However, pseudomembranous colitis related to rifampicin usage is rare. We report a case of pseudomembranous colitis which developed in a 70-year-old male patient during the first line anti-tuberculous therapy including rifampicin. The patient was diagnosed with active pulmonary tuberculosis thirty days earlier. On admission, he suffered watery diarrhea and intermittent abdominal pain for 10 days. Sigmoidoscopic examination revealed diffusely scattered whitish to yellowish pseudomembrane with skipped areas or edematous hyperemic mucosa from rectum to descending colon, and histopathologic findings were consistent with pseudomembranous colitis with typical volcano-like exudate. Symptoms improved after excluding rifampicin and treatment with metronidazole. In patients with persistent diarrhea and abdominal pain receiving anti-tuberculous therapy including rifampicin, rifampicin-associated pseudomembranous colitis should be considered.

Keyword

Pseudomembranous colitis; Rifampicin; Clostridium difficile

MeSH Terms

Abdominal Pain
Aged
Clostridium difficile
Colon
Colon, Descending
Diarrhea
Enterocolitis, Pseudomembranous*
Exudates and Transudates
Humans
Male
Metronidazole
Mucous Membrane
Rare Diseases
Rectum
Rifampin
Tuberculosis, Pulmonary
Metronidazole
Rifampin