Spontaneous pseudomembranous colitis not associated with Clostridium difficile

Cholestatic jaundice and pseudomembranous colitis following combination therapy with doxorubicin and docetaxel

We report a case of cholestatic jaundice and pseudomembranous colitis (PMC) following combination therapy with docetaxel and doxorubicin. This clinical syndrome has not been previously reported with this combination. In particular, this is the first report of non-Clostridium difficile-associated PMC with docetaxel-based chemotherapy. Docetaxel is principally metabolized by the hepatic cytochrome p450 mixed-function oxidases, in particular by the isoform CYP3A. This patient was on long-term erythromycin prophylaxis following splenectomy. Erythromycin is a known inhibitor of CYP3A. We postulate that erythromycin probably contributed to the observed clinical syndrome. Clinicians should be aware of potential drug interactions, when unusual toxicities occur with novel combinations of chemotherapeutic agents.

Clinical and pathological variability of infection by enterohaemorrhagic (Vero cytotoxin producing) Escherichia coli

The clinical and pathological features of five sporadic cases of enteric infection caused by Escherichia coli O157 (enterohaemorrhagic or Vero cytotoxin-producing E coli showed a range of features. These included one case with pseudomembranous colitis, one with an acute exacerbation of ulcerative colitis, and three with enterocolitis. Diagnostic difficulties encountered initially in four of the five cases were finally resolved by correlating the results of microbiological with histopathological investigations. In view of the heterogeneity of clinical and histological signs and symptoms, it is concluded that all patients with abdominal pain and diarrhoea or rectal bleeding should have early microbiological investigation.