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  • Title: Absence of diarrhea in toxic megacolon complicating Clostridium difficile pseudomembranous colitis.
    Author: Burke GW, Wilson ME, Mehrez IO.
    Journal: Am J Gastroenterol; 1988 Mar; 83(3):304-7. PubMed ID: 3344734.
    Abstract:
    We describe a patient with Clostridium difficile-associated pseudomembranous colitis who presented with toxic megacolon without diarrhea. The discussion includes a brief review of the literature, and suggests an important role for endoscopy in the diagnosis of pseudomembranous colitis and, possibly, as part of the therapy for toxic megacolon associated with Clostridium difficile colitis. The unusual combination of toxic megacolon without antecedent diarrhea should be recognized as a possible manifestation of antibiotic-associated pseudomembranous colitis, especially in the setting of simultaneous antimicrobial and opiate administration. Early diagnosis and disease-specific intervention can be lifesaving.
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