Colectomía como Tratamiento de Colitis Pseudomembranosa Fulminante. Reporte de un Caso y Revisión Literaria
Resumen
La colitis pseudomembranosa es un término descriptivo que se asocia a una infección colónica por Clostridioides difficile, es responsable de aproximadamente 25% de las diarreas asociadas a antibióticos con presentación de cuadros severos en su mayoría. Esta patología tiene el potencial de desarrollar complicaciones que ponen en peligro la vida como megacolon tóxico, íleo, perforación intestinal y sepsis. Presentamos el caso clínico de una mujer de 65 años, sin inmunización BCG, con antecedente de hipertensión arterial y osteoporosis en control médico, que acude al hospital por dolor lumbar crónico y progresivo. En la tomografía computarizada se identificó un absceso frío paravertebral derecho a nivel T9-T10 con destrucción ósea sin recuperación independientemente de terapia antibiótica intensiva (linezolid y levofloxacino). Finalmente se identificó infección tuberculosa, iniciándose terapia combinada antituberculosa que derivó en colitis pseudomembranosa. A los pocos días se desarrollaron características de megacolon tóxico, así como abdomen agudo con deterioro clínico abrupto. Se tomó tempranamente la decisión multidisciplinaria de realizar una colectomía total, frenando el deterioro general y resultando en una destacada mejoría clínica.
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Derechos de autor 2023 Francisco Javier Lugo Rincón-Gallardo , Ana Paula Mendoza Gaona, Francisco De la Peña Camacho, Juan Carlos Franco Rodríguez, Jorge Luis Castrejón Mora
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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