Fulminant Postcesarean Clostridium difficile Pseudomembranous Colitis

Abstract

Pseudomembranous colitis due to Clostridium difficile infection is rarely reported in the obstetric literature. This disease process is associated with prior antibiotic exposure. A term primigravida was delivered by primary cesarean for failed vacuum extraction. She received Intravenous cefazolin after cord clamping, which was continued for 36 hours for a presumptive diagnosis of endometritis. On day 3, oral amoxicillin and clavulanate was started for suspected cellulitis of the incision. She was readmitted 1 day after her discharge with severe diffuse abdominal pain and distention. Proctoscopy showed pseudomembranous colitis. Colectomy with temporary ileostomy was performed for worsening symptoms and imminent perforation. The diagnosis of pseudomembranous colitis should be considered in postpartum women who have low-grade fever, abdominal and gastrointestinal symptoms, and recent antibiotic exposure.