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Volume 7, Issue 3 (Suppl) J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X Gastro 2017
June 12-13, 2017
June 12-13, 2017 Rome, Italy
11th Global
GastroenterologistsMeeting
Huseyin Sancar Bozkurt et al., J Gastrointest Dig Syst 2017, 7:3(Suppl)
DOI: 10.4172/2161-069X-C1-050
Successful therapy of severe pseudomembranous colitis using combination of oral vancomycin and
intracolonic vancomycin
Huseyin Sancar Bozkurt and C Parlakgumus
Medical Park Private Tarsus Hospital, Turkey
Background: Clostridium difficile is a major cause of intestinal infection and diarrhoea in individuals following antibiotic treatment.
Disease associated with C. difficile infection (CDI) ranges from mild diarrhoea to pseudomembranous colitis (PMC). Severe CDI
unresponsive to intravenous (IV) metronidazole therapy requires more aggressive medical management and possible surgical
intervention. In the case of ileus, intracolonic and oral vancomycin presented a promising alternative method for administering the
antibiotic.
Methods: We reported a five year old boy had non bloody diarrhea with un-responding metronidazole treatment for 10 days. The
stool CDI cytotoxin assay was negative. The patient had no antibiotic exposure in the six weeks prior to diarrhoea. Abdominal
pain, ileus, fever, leukocytosis were occurred (figure 1). Decompressive flexible sigmoidoscopy revealed inflamed mucosa and yellow
plaque like lesions in sigmoid and descending colon (figure 2). Stool cultures and analysis for Rotavirus, Staphylococcus, Shigella,
Salmonella and Candida were negative.
Results: İntraluminal vancomycin (1 gr in 250 ml serum physiologic) was performed during flexible sigmoidoscopy. Oral vancomycin
was started (40 mg/kg) four times a day. The patient’s condition improved after treatment and three days later soft diet started
(figure-3).
Conclusion: Pediatric CDI cases found 87% reported only diarrhea, 9% had severe CDI and 4% had severe CDI with complications
(toxic megacolon, ileus, intestinal perforation). In the case of ileus, intracolonic and oral vancomycin presented a promising alternative
method for administering the antibiotic in clinical suspect of CDI associated PMC. To our knowledge, this is the first documented
case to report successful intracolonic and oral vancomycin treatment used in a child patient.
Biography
Huseyin Sancar Bozkurt has completed his PhD at the age of 24 years from Trakya University and İnternal Medicine at the age of 30 from Çukurova University.
He has completed gastroenterology education at the age of 33 years from Adana Baskent University. He has published multiple national and international papers.