Niiza Hospital, Department of Pharmacy, 3-14-30, Horinouchi, Niiza, Saitama, 352-0023, Japan.
Niiza Hospital, Department of Internal Medicine, 3-14-30, Horinouchi, Niiza, Saitama, 352-0023, Japan.
J Infect Chemother. 2019 Dec;25(12):1040-1042. doi: 10.1016/j.jiac.2019.05.009. Epub 2019 Jun 5.
Oseltamivir, an established oral anti-influenza medication, increases the risk of ischemic colitis. Baloxavir marboxil is a novel oral anti-influenza medication, and few studies have evaluated its potential side effects, including ischemic colitis. Moreover, as influenza A can also induce ischemic colitis, drug-induced colitis associated with anti-influenza medication is not clearly understood. In this report, we describe the case of a 62-year-old Japanese woman who developed acute ischemic colitis after taking baloxavir for influenza A. The day after taking baloxavir (day 2), the patient experienced abdominal pain, diarrhea, and nausea. On day 3, she had developed hematochezia and decided to visit our hospital. Upon presentation, inflammation of the descending and sigmoid colon was detected by abdominal echography and computed tomography. Fluid replacement therapy and dietary restrictions were initiated. On day 4, the inflammation of the descending colon and marked intestinal edema were confirmed by colonoscopy. She was clinically diagnosed with ischemic colitis, from which she recovered completely by day 9. This case suggests that patients taking baloxavir may be at risk of developing ischemic colitis with hematochezia and underscores the need to further study the induction of this condition by commonly used oral anti-influenza agents.
奥司他韦是一种已被广泛应用的口服抗流感药物，它会增加缺血性结肠炎的发病风险。巴洛沙韦是一种新型的口服抗流感药物，目前仅有少数研究评估了其潜在的副作用，包括缺血性结肠炎。此外，由于甲型流感也可能引起缺血性结肠炎，因此药物相关性流感治疗药物引起的结肠炎的发病机制尚不清楚。在本报告中，我们描述了一例 62 岁日本女性服用巴洛沙韦治疗甲型流感后发生急性缺血性结肠炎的病例。服用巴洛沙韦的第 2 天（即发病第 1 天），患者出现腹痛、腹泻和恶心。第 3 天，患者出现血便，并决定来我院就诊。腹部超声和 CT 检查提示降结肠和乙状结肠炎症。给予补液和饮食限制治疗。第 4 天，结肠镜检查发现降结肠炎症和明显的肠壁水肿。临床诊断为缺血性结肠炎，第 9 天患者完全康复。该病例提示服用巴洛沙韦的患者可能有发生伴有血便的缺血性结肠炎的风险，同时也需要进一步研究常用的口服抗流感药物引起这种情况的机制。
