A 79-year-old woman with a metaphalangeal arthritis received 10 days of amoxicillin-clavulanic acid and one week later ciprofloxacin.
Two days after the end of antibiotic treatment, she began with diarrheal watery stools without pathological products (both diurnal and nocturnal), fever up to 39 oC, abdominal pain and progressive decay.
He attends the emergency department several times, performing coprocultive and determination of Clostridium difficile toxin that are negative with subsequent discharge for improvement after astringent measures (although without resolution).
One week later, the patient was readmitted to the hospital due to persistent watery diarrhea, abdominal pain, fever and decay.
Analytically, only a slight normocytic normochromic anemia stands out.
When performed, ulcers of different sizes and depth are observed, with a white background and a red halo, diffusely to the ascending colon.
Biopsies confirmed the diagnosis.
Hemocultives were extracted due to fever that were positive for Clostridium ramosum.
After endoscopic suspicion, treatment with metronidazole was started, which was maintained for 15 days with good subsequent evolution.
