A Case of Pseudomembranous Colitis Presenting as Toxic Megacolon and Protein Losing Enteropathy

With increasing therapeutic and prophylactic use of antibiotics, Clostridium difficile colitis or antibiotics-induced colitis has become a major clinical problem. The clinical spectrum of presentation of antibiotics-induced colitis ranges from an asymptomatic carrier state to fulminant toxic colitis or toxic megacolon. Toxic megacolon and protein losing enteropathy have rarely been reported in the course of antibiotic-induced pseudomembranous colitis. We experienced a 68-year-old patient who was referred to our hospital due to abdominal distension, edema, fever, and diarrhea two days after spine operation. We could diagnose the case as toxic megacolon and protein losing enteropathy complicated by pseudomembranous colitis. After conservative management including removal of the offending antibiotics, bowel rest, and oral metronidazole, the patient completely improved.