항암제에 의한 위막성 대장염 1예

Abstract

Pseudomembranous colitis is a potentially severe from of colitis that that occurs almost exclusively in the presence of antibiotic exposure. Less commonly implicated are antineoloastic agents and very few other conditions. We report a case who had diarrhea due to pseudomembranous colitis after receiving chemotherapy for canver. A 38-year-old woman with metastatic adnenocotical carcinoma was admitted with diarrhea of 12 days duration. Twenty-four days before onset of diarrhea, she had received rtoposide, pelemycin, and cispaltin by intravenous infusion. On admission, she comlpained of abdominical pain, diarrhea, and fever. She was dehydrated, hypotensive, and tachypneic. Her abdomen was distended with absent bowel sounds, She was not neutropenic. Diagnosis of pseudomembranous colitis was confirmed by endoscopic ewamination, positive biblopsy specimen and culture of C. difficile in the stool. She recovered after receiving vancomycin and metronidazole arally. Patients with severe diarrhea after receiving anticancer chemotherapy should be promptly tested for pseudomembranous colitis even in the absence of a history of antibiotic administration.