In many instances patients who have undergone neurosurgery are given
antibiotics. Some of these patients, however, run the risk of developing
pseudomembranous colitis. In our department over the past three years, 239 patients, whose hospitalization period exceeded two weeks, were given
antibiotics. Of this total number, 6 patients (2.5%) contacted
pseudomembranous colitis and a clinical study of these 6 cases was conducted from a neurosurgical viewpoint. This study concentrated on
diarrhea, the primary symptom, and the 6 patients consisted of 1 male and 5 females whose ages ranged from 61 to 75 years. All had undergone surgery, and a breakdown of their diseases is as follows: 2 cases of a
subarachnoid hemorrhage, 2 cases of an
intracerebral hemorrhage, 1 case involving a
glioblastoma multiforme, and a case of
normal pressure hydrocephalus.
Diarrhea was present in all 6 cases and, additionally,
pyrexia,
abdominal pains, and
leukocytosis were seen. On colonoscopic examination, 5 patients were diagnosed as having developed
pseudomembranous colitis, and were treated by
oral administrations of
Vancomycin. In the remaining cases, in which a colonoscopic examination had not been performed, a diagnosis of
pseudomembranous colitis had not been achieved and, subsequently, one patient died of
multiple organ failure. On autopsy, however, it was determined that the patient had had
pseudomembranous colitis. Thus, if symptoms of
diarrhea occur during or after administrations of
antibiotics, the possibility of
pseudomembranous colitis must be assumed, and a colonoscopic examination should be performed immediately, so as to detect the disease at an early stage. This condition can be transmitted within a hospital and, therefore, great emphasis must be placed on preventing
secondary infections.