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Abstract
Introducción: La colitis pseudomembranosa es una patología relacionada con el uso de antibióticos. En raras ocasiones evolucionará a un megacolon tóxico que podría requerir resolución quirúrgica.
Presentación del caso: Mujer de 22 años, que recibió amoxicilina/clavulánico días previos a la consulta. Presentó diarrea, fiebre y vómitos. Rx abdomen y TAC abdomen: Distención de colon derecho >6 cm. Toxina para clostridium: Positiva. Inicia tratamiento médico, requieriendo tratamiento quirúrgico por megacolon tóxico.
Discusión: El megacolon tóxico constituye una complicación infrecuente de la colitis pseudomembranosa. Es rara su presentación en pacientes jóvenes y sin comorbilidades. Al diagnóstico se llega mediante los criterios de Jalán. Estos pacientes pueden tener una mortalidad cercana al 70%.
Conclusión: Se debe mantener alto nivel de alerta ante signos de toxicidad sistémica y la presencia de dilatación colónica es diagnostica de la entidad. El uso indiscriminado de antibióticos constituye un serio factor de riesgo.
Palabras Claves: Megacolon, Colitis Pseudomembranosa, Terapia Intensiva
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– S. B. Debast, M. P. Bauer and E. J. Kuijper on behalf of the Committee. European Society of Clinical Microbiology and Infectious Diseases: Update of the Treatment Guidance Document for Clostridium difficile Infection. Clin Microbiol Infect 2014; 20 (Suppl. 2): 1–26
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