抗生物質による急性出血性大腸炎の1例

Acute Hemorrhagic Colitis Due to Antibiotics, Report of a Case

　抗生物質に起因する腸炎として古くから偽膜性腸炎が知られているが，最近，偽膜形成のない出血性腸炎の報告例もよくみられるようになった．以下，典型的と思われる出血性大腸炎の症例を呈示すると共に，若干の考察を加えて，報告する．

　A report is made of a typical case of acute hemorrhagic colitis due to antibiotics. A reference is made also to our study of the results of 31 cases experienced by us in recent three years.

　The patient, a 46-year-old woman, was given a total amount of 6,250 mg of AMPC because of bronchins. Two days later abdominal pain, nausea and hemorrhagic diarrhea appeared. Endoscopy of the large intestine showed from the sigmoid to descending colon mucosal edema, turbid and accompanied with diffuse, fresh mucosal bleeding. Histologically, the biopsy specimen showed edema, engorgement and slight infiltration of inflammatory cells. Fecal culture disclosed Klebsiella oxytoca. After conservative therapy endoscopic examination five days later showed only here and there residual reddening. No bleeding was recognized. Twelve days later, there was no abnormal findings.

　We have experienced in the recent three years 31 cases of similar hemorrhagic colitis caused by antibiotics given per os. Synthesized penicillin accounted for 25 cases. It was administered mostly for relatively mild diseases such as common cold, bronchitis or cystitis. The lesion was most often seen on the left side of the colon. A representative case is illustrated.