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Pseudomembranous colitis (PMC) is uncommon in the infant and complications requiring
surgical intervention are rare. All prior cases have involved the direct administration
of antibiotics to the child. A 2-month-old girl required bowel resection for perforation
of a thickened and inflamed left colon. Findings were consistent with PMC and the
stool was Clostridium difficile toxin positive. The patient was treated with vancomycin and did well. The patient's
mother later admitted to self-administration of ciprofloxacin while breast-feeding
her infant. Oral doses of this drug are concentrated in breast milk at levels higher
than serum. Antibiotics derived from breast milk can cause complicated PMC in the
infant. A directed history can establish an early diagnosis and help distinguish PMC
from other more common infantile enterocolitides.
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References
- Clostridium difficile colitis.Adv Intern Med. 1984; 29: 85-107
- Pseudomembranous colitis: Pathogenesis and therapy.Med Clin North Am. 1982; 66: 655-665
- Antibiotic-associated colitis.in: Mandell GL Principles and Practice of Infectious Disease. Churchill Livingstone, New York, NY1990: 863-869
- Mode of action of the quinolone antimicrobial agents: review of recent information.Rev Infect Dis. 1989; 11: S902-S911
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- Severe pseudomembranous colitis in a child: Case report and literature review.Pediatr Infect Dis J. 1989; 8: 876-882
- Role of surgery in antibiotic-induced pseudomembranous enterocolitis.Am J Surg. 1990; 160: 535-539
Article info
Footnotes
*Presented at the 24th Annual Meeting of the Pacific Association of Pediatric Surgeons, Hong Kong, May 20–24, 1991.
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Copyright
© 1992 W.B. Saunders Company. All right reserved. Published by Elsevier Inc.
