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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 46
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
Successful Therapy of Severe Pseudomembranous Colitis using Combination of Oral Vancomicin and
İntracolonic Vancomycin
H S Bozkurt
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 frommild 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 5 year old boy had non bloody diarrhea with unresponding metronidazol 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 occured(Figure-1). Decompressive fleksible sigmoidoscopy revealed
inflamed mucosa and yellow plaque like lesions in sigmoid and descending colon(Figure-2).Stool cultures and analysis for
rotavirus,staphylococus,shigella,salmonella and candida were negative.
Results:
İntraluminal vancomycin (1 gr in 250 ml serum physiologic) was performed during fleksible 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 assosiciated PMC.
sancarb79@gmail.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083