Vancomycin, metronidazole で好中球減少を呈した nonantibiotic-associated pseudomembranous colitis の1例

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A case of non-antibiotic-associated pseudomembranous colitis with vancomycin-and/or metronidazole-induced neutropenia is reported. A 74-year-old female with diabetes mellitus, diagnosed 10 years previously, suddenly developed watery diarrhea in November, 1986. She had not been taking antibiotics for several weeks before onset. A diagnosis of pseudomembra-nous colitis was made from the findings of sigmoidoscopy, which showed numerous round white noduli in the rectosigmoid. The symptoms subsided after administration of vancomycin and metronidazole. However, diarrhea reappeared on the 7 th day after withdrawal of the drugs, and pseudomembrane was again observed in the rectosigmoid. She was referred to our department after vancomycin had been re-administered. She was initially treated with vancomycin in our department, and then with metronidazole for relapse. Her neutrophil count was 6723/mm3 (WBC 7500/mm3) before the initial treatment, and then gradually decreased to 368/ mm3 (WBC 2300/mm3) during treatment of the relapse. It could not be determined whether vancomycin and/or metronidazole had caused the neutropenia.
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