P Ang1, W K Cheong, K S Khoo. 1. Department of Medical Oncology, National Cancer Centre, Singapore. dmoacs@nccs.com.sg
Abstract
INTRODUCTION: The concomitant antimicrobial properties of antineoplastic agents may play a role in causing pseudomembranous colitis, which has been documented for cisplatin, cyclophosphamide and 5-fluorouracil. CLINICAL PICTURE: We describe the first case reported in the English literature of severe pseudomembranous colitis occurring in a patient given paclitaxel as adjuvant chemotherapy for breast cancer. There was no prior antibiotic therapy. Stool culture confirmed Clostridium difficile. TREATMENT: Oral vancomycin, metronidazole and cholestyramine led to prompt improvement of intestinal symptoms, which resolved in two weeks. OUTCOME: Repeat colonoscopy performed 3 months later showed total resolution of the colitis. CONCLUSIONS: Awareness of pseudomembranous colitis after paclitaxel chemotherapy can avert life-threatening complications.
INTRODUCTION: The concomitant antimicrobial properties of antineoplastic agents may play a role in causing pseudomembranous colitis, which has been documented for cisplatin, cyclophosphamide and 5-fluorouracil. CLINICAL PICTURE: We describe the first case reported in the English literature of severe pseudomembranous colitis occurring in a patient given paclitaxel as adjuvant chemotherapy for breast cancer. There was no prior antibiotic therapy. Stool culture confirmed Clostridium difficile. TREATMENT: Oral vancomycin, metronidazole and cholestyramine led to prompt improvement of intestinal symptoms, which resolved in two weeks. OUTCOME: Repeat colonoscopy performed 3 months later showed total resolution of the colitis. CONCLUSIONS: Awareness of pseudomembranous colitis after paclitaxel chemotherapy can avert life-threatening complications.