Clostridium difficile-associated diarrhea caused by anti-tuberculosis drugs: a case report and literature review

doi:10.3969/j.issn.1000-6621.2020.03.021

Abstract

Abstract:

Antimicrobial agent exposure is a risk factor for Clostridium difficile-associated diarrhea (CDAD), whereas the use of anti-tuberculous (anti-TB) drugs is rarely associated with it. This article reports a case of CDAD associated with anti-TB drugs, and reviews relevant literatures. A 32-year-old woman with pulmonary tuberculosis who had been treated with anti-TB agents for 9 months was admitted for abdominal pain and diarrhea. The test results of Clostridium difficile toxin and glutamate dehydrogenase (GHD) were both positive. Symptoms were relieved after anti-TB drugs were discontinued and treatment with vancomycin and bifidobacterium was given for 9 days. By reviewing literatures, the authors have discussed the pathogenesis, clinical manifestations, diagnosis and treatment of CDAD, in order to remind clinicians to understand the rare complications in the process of tuberculosis treatment, and to avoid pseudomembranous colitis (PMC) and other serious intestinal diseases by early diagnosis and intervention.

Key words: Tuberculosis, pulmonary, Antitubercular agents, Brevibacillus, Diarrhea, Consensus development conferences as topic

WANG Jing,ZHANG Meng,HE Jian-qing. Clostridium difficile-associated diarrhea caused by anti-tuberculosis drugs: a case report and literature review[J]. Chinese Journal of Antituberculosis, 2020, 42(3): 293-296. doi: 10.3969/j.issn.1000-6621.2020.03.021

Figures/Tables 2

References 25

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第一作者及参考文献	性别	年龄 (岁)	结核部位或类型	并发症	抗结核药物	潜伏期 (d)	大便Cd 毒素	大便Cd 培养	肠镜	是否停用利福平	治疗用药
Moriarty^[6]	男	57	肾	无	H-R-E	42	未提及	阴性	阳性	是	无
Klaui^[7]	女	64	血行播散性	无	H-R-E	26	未提及	阳性	未查	是	万古霉素
Park^[8]	男	90	肺	无	H-R-Z-E	30	阴性	阴性	阳性	是	甲硝唑
Sun^[9]	女	63	心包	无	H-R-Z-E	120	阳性	未提及	未查	是	甲硝唑、乳酸菌
Nakajima^[10]	女	49	肺、胸膜	自身免疫性肝炎	H-R-E	67	未提及	阴性	阳性	是	乳酸菌
Chen^[11]	女	28	肺	无	H-R-Z-E	126	未提及	未提及	阳性	是	无
Choi^[12]	男	74	肺	无	H-R-Z-E	120	未提及	未提及	阳性	是	甲硝唑
Yim^[13]	男	81	肺	无	H-R-Z-E	30	阳性	阴性	阳性	是	甲硝唑
Akbar^[14]	女	43	腹腔淋巴结	无	H-R-Z-E	90	未提及	未提及	阳性	否	甲硝唑
Kim^[15]	女	50	肺	糖尿病	H-R-Z-E	55	未提及	未提及	阳性	是	甲硝唑
Choi^[16]	女	65	肠道	直肠癌、高血压、糖尿病	H-R-Z-E	60	阳性	未提及	阳性	是	甲硝唑
Byrd^[17]	男	60	肺	无	H-R-E	120	阳性	阳性	阳性	是	甲硝唑
Fournier^[18]	女	59	血行播散性	无	H-R-E	20	未提及	未提及	阳性	是	万古霉素