[Value of rectosigmoidoscopy with bacteriological culture of colonic biopsies in the diagnosis of post-antibiotic hemorrhagic colitis related to Klebsiella oxytoca].

UNLABELLED

We report 7 cases of antibiotic-associated and hemorrhagic colitis due to Klebsiella oxytoca. The diagnosis was performed by sigmoidoscopy with bacteriological biopsy culture.

PATIENTS AND METHODS

Nine patients, aged 25-83 years, were hospitalized from February 1993 to October 1995 with hemorrhagic acute diarrhea following antibiotic treatment: amoxicillin (n = 3). amoxicillin-clavulanic acid (n = 4), cephalosporine (n = 2). All patients have had two stool samples cultures including Clostridium difficile toxin detection. Sigmoidoscopy with collection of biopsy specimens for bacteriological cultures was performed routinely.

RESULTS

Endoscopic findings established the diagnosis of colitis in all cases: rectitis (n = 1), diffuse left colitis (n = 4), segmental left colitis (n = 4). The lesions were erythematous and purpuric (n = 5) or ulcerative (n = 4). Stool culture was normal in all cases but Klebsiella oxytoca was isolated in 7 cases (78%).

CONCLUSIONS

Sigmoidoscopy and bioptic microbiology ensured the diagnosis of antibiotic-associated hemorrhagic colitis due to Klebsiella oxytoca.