title: A case of severe pseudomembranous colitis diagnosed by colonoscopy after Helicobacter pylori eradication.
abstract: A 65-year-old male was admitted for hemorrhagic gastric ulcer. Since anti-Helicobacter pylori-immunoglobulin G antibody tested positive, eradication therapy was administered using rabeprazole, amoxicillin, and clarithromycin. During hospitalization, colonoscopy showed normal colonic mucosa except for a polyp of the sigmoid colon. He was discharged 4 days after finishing eradication therapy, but fever up and diarrhea appeared on the following day. After re-admission, colonoscopy revealed multiple yellowish-white, small circular membranous elevations, and a diagnosis of pseudomembranous colitis was made. He was successfully treated by oral administration of vancomycin. Concomitant use of antibiotics and a proton pump inhibitor for a hospitalized patient is a risk for pseudomembranous colitis. However, H. pylori eradication therapy should be started at re-introduction of oral feeding in cases of bleeding ulcers because rebleeding can be mortal in patients in 'poor general condition'. Physicians should consider pseudomembranous colitis as a diagnosis for the patients with diarrhea and high fever following H. pylori eradication therapy.
authors.affiliation: Department of Gastroenterology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan, satoshi198562@gmail.com.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Chinda
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Yamai
authors.forename: Ryu
authors.initials: R
authors.lastname: Satake
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Soma
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimoyama
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D003113:Colonoscopy; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000209:etiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D012074:Remission Induction; D012720:Severity of Illness Index