A 69-year-old woman underwent a left laparoscopic oophorectomy 6 days earlier due to cyst without requiring prophylactic antibiotic therapy.
She was readmitted for diarrheas that began on the first postoperative day.
A CT scan showed colonic dilatation and inflammatory changes in the rectosigmoid wall.
In the sigmoidoscopy, ulcerations and pseudomembranes appear in the mucosa.
The patient was referred for PC (with compatible biopsies) and treated with metronidazole.
Detection of toxin A and B by CD in faeces is negative as is coprocultive and HIV serology.
Due to a torpid evolution with vomiting and megacolon without toxemia, 12 days later she is urgently intervened performing a subtotal colectomy with ileostomy.
Postoperatively, she was admitted to the ICU and required vasoactive drugs due to multiple organ failure.
On the 5th day she presented hemodynamic instability due to upper gastrointestinal bleeding and ischemia in the ileostomy.
Endoscopy showed a friable, necrotic and ulcerated mucosa from the esophagus to the duodenum.
The pathological results of the surgical specimen report pseudomonas colitis associated with chronic non-tuberculous colitis (immunohistochemistry technique) (1), starting treatment with foscarnet but the patient dies in multisystem failure
Biopsies of the initial sigmoidoscopy were reviewed without evidence of inclusion bodies.
