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Pseudomembranous colitis - Overview

Alternative Names

Antibiotic-associated colitis; Colitis - pseudomembranous; Necrotizing colitis

Definition of Pseudomembranous colitis:

Pseudomembranous colitis is infection of the large intestine (colon) with an overgrowth of Clostridium difficile bacteria.

Causes, incidence, and risk factors:

The Clostridium difficile bacteria is normally present in the intestine. However, it may overgrow when antibiotics are taken. The bacteria release a powerful toxin that causes the symptoms. The lining of the colon becomes inflamed and bleeds, and takes on a characteristic appearance called pseudomembranes.

Ampicillin, clindamycin, and cephalosporins are the most common antibiotics associated with this disease in children. Pseudomembranous colitis is rare in infants younger than 12 months old because they have protective antibodies from the mother and because the toxin does not cause disease in most infants.

Most cases of pseudomembranous colitis happen when a person is in the hospital, because the bacteria can spread from one patient to another.

Risk factors include:

Advanced age
Antibiotic use
Chemotherapy
Medications that suppress the immune system
Recent surgery
Personal history of pseudomembranous colitis

Digestive system

Digestive system organs

Reviewed last on: 4/12/2010
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Aslam S. An update on diagnosis, treatment, and prevention of Clostridium difficile-associated disease. Gastroenterol Clin North Am. Jun 2006;35(2):315-335.

Bartlett JG. Clostridial infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa : Saunders Elsevier; 2007: chap 319.

Thielman NM, Wilson KH. Antibiotic-associated colitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 96.

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