Ewha Med J.  2015 Mar;38(1):54-58. 10.12771/emj.2015.38.1.54.

Pseudomembranous Colitis: A Complicated Case with Transient Increase of Carcinoembryonic Antigen

• Nam DI
• Kang C
• Jung IH
• Moon HG
• Youn BR
• Lee NH

• KMID: 2171331
• DOI: http://doi.org/10.12771/emj.2015.38.1.54

Abstract

Pseudomembranous colitis (PMC) is a frequent cause of morbidity and mortality among hospitalized patients. Although diarrhea is the most common manifestation, PMC may be associated with intraperitoneal fluid accumulation in the severe cases. And a few cases showing both ascites and pleural effusion have been reported in patients with PMC. We report a case of PMC who showed elevated serum and ascites levels of carcinoembryonic antigen (CEA) with a normal CEA level in pleural effusion and who successfully recovered after oral administration of metronidazole. After treatment, the serum CEA level returned to the reference range.

Keyword

Pseudomembranous colitis; Ascites; Pleural effusion; Carcinoembryonic antigen

MeSH Terms

Administration, Oral
Ascites
Carcinoembryonic Antigen*
Diarrhea
Enterocolitis, Pseudomembranous*
Humans
Metronidazole
Mortality
Pleural Effusion
Reference Values
Carcinoembryonic Antigen
Metronidazole

Figure

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  Fig. 1 Chest radiograph upon admission. (A) It shows diffuse ground glass opacities, peribronchial infiltrations in both lungs, and bilateral costophrenic angle blunting. (B) Right decubitus chest radiograph shows a moderate amount of pleural effusion.

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  Fig. 2 Abdominal computed tomography (CT). (A) It shows diffuse wall thickening of the colonic loops and a moderate amount of ascites. (B) Marked improvement in the diffuse wall thickening of the colonic loops and no ascites are present on day 21 of treatment.

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  Fig. 3 Endoscopic findings. (A) Flexible sigmoidoscopy shows multiple diffuse, yellowish plaques on edematous mucosa. (B) Colonoscopy shows the absence of both the mucosal edema and pseudomembrane on day 21 of treatment.

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