Steroid-refractory ulcerative colitis treated with corticosteriods, metronidazole and vancomycin: A case report

Jonathan Miner, M. Monem Gillan, Philip Alex, Michael Centola

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Increasing evidence elucidating the pathogenic mechanisms of ulcerative colitis (UC) has accumulated and the disease is widely assumed to be the consequence of genetic susceptibility and an abnormal immune response to commensal bacteria. However evidence regarding an infectious etiology in UC remains elusive. Case presentation: We report a provocative case of UC with profound rheumatologic involvement directly preceded by Clostridium difficile infection and accompanying fever, vomiting, bloody diarrhea, and arthritis. Colonic biopsy revealed a histopathology suggestive of UC. Antibiotic treatment eliminated detectable levels of enteric pathogens but did not abate symptoms. Resolution of symptoms was procurable with oral prednisone, but tapering of corticosteroids was only achievable in combination therapy with vancomycin and metronidazole. Conclusions: An infectious pathogen may have both precipitated and exacerbated autoimmune disease attributes in UC, symptoms of which could be resolved only with a combination of corticosteroids, vancomycin and metronidazole. This may warrant the need for more perceptive scrutiny of C. difficile and the like in patients with UC.

Original languageEnglish
Article number3
JournalBMC Gastroenterology
Volume5
DOIs
StatePublished - Jan 24 2005
Externally publishedYes

Fingerprint Dive into the research topics of 'Steroid-refractory ulcerative colitis treated with corticosteriods, metronidazole and vancomycin: A case report'. Together they form a unique fingerprint.

  • Cite this