Document 0699
 DOCN  M9650699
 TI    Pseudomonas aeruginosa as a cause of infectious diarrhea successfully
       treated with oral ciprofloxacin.
 DT    9605
 AU    Porco FV; Visconte EB; Department of Internal Medicine, Lutheran Medical
       Center,; Brooklyn, NY 11220, USA.
 SO    Ann Pharmacother. 1995 Nov;29(11):1122-3. Unique Identifier : AIDSLINE
       MED/96156285
 AB    OBJECTIVE: To describe an immunocompromised patient (without AIDS) with
       nosocomial infectious diarrhea caused by Pseudomonas aeruginosa. Oral
       ciprofloxacin therapy proved to be effective. CASE SUMMARY: An
       80-year-old woman with type II diabetes mellitus and hypertension
       developed progressive renal insufficiency, was hospitalized because of
       uremia, and underwent hemodialysis. When the patient developed
       hematochezia, Duke's C sigmoid colon cancer was detected and
       successfully resected. She received broad-spectrum antibiotics in the
       perioperative period. The patient then developed profuse diarrhea
       associated with abdominal cramping, a low-grade fever, prostration, and
       headache. The patient then started to received vancomycin 500 mg po qid
       empirically. Four days later, the diarrhea continued unabated, the
       Clostridium difficile titer was negative, and the vancomycin therapy was
       stopped. However, the stool culture was positive for heavy growth of P.
       aeruginosa sensitive to ciprofloxacin. The patient then began to receive
       ciprofloxacin 500 mg po bid. Within 3 days the diarrhea stopped. Oral
       ciprofloxacin therapy was continued for 10 days and the patient remained
       free of symptoms with formed stools thereafter. DISCUSSION: Diarrhea
       following the use of broad-spectrum antibiotics implicates
       pseudomembranous colitis as the cause. The patient did not respond to
       oral vancomycin therapy and had a negative stool assay for C. difficile
       toxin. This patient was believed to have Pseudomonas enteritis, which
       was confirmed by 2 positive stool cultures. The administration of oral
       ciprofloxacin therapy stopped her diarrhea with a rapid resolution of
       symptoms. CONCLUSIONS: P. aeruginosa as a cause of infectious diarrhea
       is unusual. When it occurs, it usually represents a nosocomial infection
       in an immunocompromised host. This report illustrates that oral
       ciprofloxacin therapy is effective for Pseudomonas enteritis, with rapid
       resolution of symptoms.
 DE    Administration, Oral  Aged  Aged, 80 and over  Anti-Infective Agents,
       Fluoroquinolone/ADMINISTRATION & DOSAGE/  PHARMACOLOGY/*THERAPEUTIC USE
       Case Report  Ciprofloxacin/ADMINISTRATION &
       DOSAGE/PHARMACOLOGY/*THERAPEUTIC  USE  Cross Infection/DRUG
       THERAPY/*MICROBIOLOGY  Diabetes Mellitus,
       Non-Insulin-Dependent/COMPLICATIONS  Diarrhea/DRUG THERAPY/*MICROBIOLOGY
       Female  Human  Hypertension/COMPLICATIONS  Immunocompromised Host
       Kidney Failure/COMPLICATIONS  Pseudomonas aeruginosa/*ISOLATION & PURIF
       Pseudomonas Infections/DRUG THERAPY/*MICROBIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).