Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing
임선영, 구자설, 김예지, 박상정, 김진남, 정성우, 임형준, 이상우, 최재현, 김창덕,
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임선영 ( Yim Sun-Young )
고려대학교 의과대학 내과학교실
구자설 ( Koo Ja-Seol )
고려대학교 의과대학 내과학교실
김예지 ( Kim Ye-Ji )
고려대학교 의과대학 내과학교실
박상정 ( Park Sang-Jung )
고려대학교 의과대학 내과학교실
김진남 ( Kim Jin-Nam )
인제대학교 의과대학 서울백병원 내과학교실
정성우 ( Jung Sung-Woo )
고려대학교 의과대학 내과학교실
임형준 ( Yim Hyung-Joon )
고려대학교 의과대학 내과학교실
이상우 ( Lee Sang-Woo )
고려대학교 의과대학 내과학교실
최재현 ( Choi Jai-Hyun )
고려대학교 의과대학 내과학교실
김창덕 ( Kim Chang-Duck )
고려대학교 의과대학 내과학교실
KMID : 0359020110440020137
Abstract
Pseudomembranous colitis (PMC) is known to be associated with antibiotic treatment, but is not commonly related to antitubercular (anti-TB) agent, rifampin. PMC is frequently localized to rectum and sigmoid colon, which can be diagnosed with sigmoidoscopy. We report a case of rifampin-induced PMC with rectosigmoid sparing in a pulmonary tuberculosis patient. An 81-year-old man using anti-TB agents was admitted with a 30-day history of severe diarrhea and general weakness. On colonoscopy, nonspecific findings such as mucosal edema and erosion were found in sigmoid colon, whereas multiple yellowish plaques were confined to cecal mucosa only. Biopsy specimen of the cecum was compatible with PMC. Metronidazole was started orally, and the anti-TB medications excluding rifampin were readministerred. His symptoms remarkably improved within a few days without recurrence. Awareness of rectosigmoid sparing PMC in patients who develop diarrhea during anti-TB treatment should encourage early total colonoscopy.
키워드
Enterocolitis; pseudomembranous; Antitubercular agent; Rifampin; Colonoscopy
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