Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Clostridium difficile Colitis Associated With Cancer Chemotherapy

Clostridium difficile Colitis Associated With Cancer Chemotherapy Abstract • Administration of cancer chemotherapeutic agents to humans and animals is frequently complicated by diarrhea and enterocolitis. Clostridium difficile and its toxin were found in the stools of two patients with colitis after chemotherapy for malignant neoplasms. Diarrhea in both patients resolved with oral vancomycin hydrochloride therapy. Clostridium difficile was also isolated from several fomites within the room of one of these patients and also from the hands of his nurses. Based on these two recent experiences, we believe patients with cancer and diarrhea or signs suggestive of colitis should be studied for toxigenic C difficile and appropriate isolation techniques employed. (Arch Intern Med 1982;142:333-335) References 1. Baskerville A, Batter-Hatton D: Intestinal lesions induced experimentally by methotrexate. Br J Exp Pathol 1977;58:663-669. 2. Slavin RE, Dias MA, Saral R: Cytosine arabinoside-induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols. Cancer 1978;42:1747-1759.Crossref 3. Prolla JC, Kirsner JB: The gastrointestinal lesions and complications of the leukemias. Ann Intern Med 1964;61:1084-1099. 4. Wagner ML, Rosenberg HS, Fernbach DJ, et al: Typhlitis: A complication of leukemia in childhood. AJR 1970;109:341-350. 5. Dosik GM, Luna M, Valdivieso M, et al: Necrotizing colitis in patients with cancer. Am J Med 1979;67:646-656.Crossref 6. Milles SS, Muggia AL, Spiro HM: Colonic histologic changes induced by 5-fluorouracil. Gastroenterology 1962;43:391-399. 7. White RS, Fuqua WB, Barrett 0: The effect of 5-fluorouracil on small bowel mucosa. J Surg Oncol 1971;3:501-506.Crossref 8. Cudmore M, Silva J, Fekety R: Clostridial enterocolitis produced by methotrexate in hamsters, abstracted. Clin Res 1979;27:383. 9. Bartlett JG, Moon N, Chang TW, et al: Role of Clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastroenterology 1978;75:778-782. 10. George WL, Sutter VL, Citron D, et al: Selective and differential medium for isolation of Clostridium difficile. J Clin Microbiol 1979;9:214-219. 11. Holdeman LV, Cato EP, Moore WEC (eds): Anaerobe Laboratory Manual , ed 4. Blacksburg, Va, Virginia Polytechnic Institute, 1977, pp 79-106. 12. Goodman LS, Gilman A: The Pharmacological Basis of Therapeutics , ed 5. New York, McMillan Publishing Co Inc, 1975, pp 1268-1279. 13. Jeynes BJ, Altmann GG: Light and scanning electron microscopic observations of the effects of sublethal doses of methotrexate on the rat small intestine. Anat Rec 1978;191:1-17.Crossref 14. Rifkin GD, Fekety FR, Silva J: Antibiotic-induced colitis: Implication of a toxin neutralized by Clostridium sordellii antitoxin. Lancet 1977;2:1103-1106.Crossref 15. Larson HE, Price AB, Honour P: Clostridium difficile and the etiology of pseudomembranous colitis. Lancet 1978;1:1063-1066.Crossref 16. Rifkin GD, Fekety R, Silva J: Neutralization by Clostridium sordellii antitoxin of toxins implicated in clindamycin-induced cecitis in the hamster. Gastroenterology 1978;75:422-424. 17. Bartlett JG, Chang TW, Gurwith M, et al: Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 1978;298:531-534.Crossref 18. Keighley MRB, Burdon DW, Arabi Y, et al: Randomized controlled trial of vancomycin for pseudomembranous colitis and post-operative diarrhea. Br Med J 1978;2:1667-1669.Crossref 19. Tedesco F, Markham R, Gerwith M, et al: Oral vancomycin for antibiotic-associated pseudomembranous colitis. Lancet 1978;2:226-228.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Clostridium difficile Colitis Associated With Cancer Chemotherapy

Loading next page...
 
/lp/american-medical-association/clostridium-difficile-colitis-associated-with-cancer-chemotherapy-jVzTj0wq6l
Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340150133022
Publisher site
See Article on Publisher Site

Abstract

Abstract • Administration of cancer chemotherapeutic agents to humans and animals is frequently complicated by diarrhea and enterocolitis. Clostridium difficile and its toxin were found in the stools of two patients with colitis after chemotherapy for malignant neoplasms. Diarrhea in both patients resolved with oral vancomycin hydrochloride therapy. Clostridium difficile was also isolated from several fomites within the room of one of these patients and also from the hands of his nurses. Based on these two recent experiences, we believe patients with cancer and diarrhea or signs suggestive of colitis should be studied for toxigenic C difficile and appropriate isolation techniques employed. (Arch Intern Med 1982;142:333-335) References 1. Baskerville A, Batter-Hatton D: Intestinal lesions induced experimentally by methotrexate. Br J Exp Pathol 1977;58:663-669. 2. Slavin RE, Dias MA, Saral R: Cytosine arabinoside-induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols. Cancer 1978;42:1747-1759.Crossref 3. Prolla JC, Kirsner JB: The gastrointestinal lesions and complications of the leukemias. Ann Intern Med 1964;61:1084-1099. 4. Wagner ML, Rosenberg HS, Fernbach DJ, et al: Typhlitis: A complication of leukemia in childhood. AJR 1970;109:341-350. 5. Dosik GM, Luna M, Valdivieso M, et al: Necrotizing colitis in patients with cancer. Am J Med 1979;67:646-656.Crossref 6. Milles SS, Muggia AL, Spiro HM: Colonic histologic changes induced by 5-fluorouracil. Gastroenterology 1962;43:391-399. 7. White RS, Fuqua WB, Barrett 0: The effect of 5-fluorouracil on small bowel mucosa. J Surg Oncol 1971;3:501-506.Crossref 8. Cudmore M, Silva J, Fekety R: Clostridial enterocolitis produced by methotrexate in hamsters, abstracted. Clin Res 1979;27:383. 9. Bartlett JG, Moon N, Chang TW, et al: Role of Clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastroenterology 1978;75:778-782. 10. George WL, Sutter VL, Citron D, et al: Selective and differential medium for isolation of Clostridium difficile. J Clin Microbiol 1979;9:214-219. 11. Holdeman LV, Cato EP, Moore WEC (eds): Anaerobe Laboratory Manual , ed 4. Blacksburg, Va, Virginia Polytechnic Institute, 1977, pp 79-106. 12. Goodman LS, Gilman A: The Pharmacological Basis of Therapeutics , ed 5. New York, McMillan Publishing Co Inc, 1975, pp 1268-1279. 13. Jeynes BJ, Altmann GG: Light and scanning electron microscopic observations of the effects of sublethal doses of methotrexate on the rat small intestine. Anat Rec 1978;191:1-17.Crossref 14. Rifkin GD, Fekety FR, Silva J: Antibiotic-induced colitis: Implication of a toxin neutralized by Clostridium sordellii antitoxin. Lancet 1977;2:1103-1106.Crossref 15. Larson HE, Price AB, Honour P: Clostridium difficile and the etiology of pseudomembranous colitis. Lancet 1978;1:1063-1066.Crossref 16. Rifkin GD, Fekety R, Silva J: Neutralization by Clostridium sordellii antitoxin of toxins implicated in clindamycin-induced cecitis in the hamster. Gastroenterology 1978;75:422-424. 17. Bartlett JG, Chang TW, Gurwith M, et al: Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 1978;298:531-534.Crossref 18. Keighley MRB, Burdon DW, Arabi Y, et al: Randomized controlled trial of vancomycin for pseudomembranous colitis and post-operative diarrhea. Br Med J 1978;2:1667-1669.Crossref 19. Tedesco F, Markham R, Gerwith M, et al: Oral vancomycin for antibiotic-associated pseudomembranous colitis. Lancet 1978;2:226-228.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1982

References