Pseudomembranous enterocolitis. Resurgence related to newer antibiotic therapy

Six patients with pseudomembranous entercolitis were seen at one institution over a 6 mth period. Clindamycin therapy preceded the diagnosis in all 6 patients and possibly caused the disease in 5 cases. Common clinical features included diarrhea, abdominal pain, fever, leukocytosis, radiographic findings of large bowel dilatation with mucosal thickening and a characteristic sigmoidoscopic or gross pathologic demonstration of discrete yellow white plaques on an otherwise normal mucosa. Complications included toxic megacolon and sigmoid colon perforation. Two of 6 patients died. The literature since 1970 is tabulated to clarify the clinical and pathological features of pseudomembranous enterocolitis associated with newer antibiotic therapy. Lincomycin and clindamycin are strongly inplicated in the recent resurgence of this formerly rare variety of colitis.