Abstract
A 32-year-old male presented with diarrhoea, mucus and bleeding per rectum. On the basis of sigmoidoscopy, rectal mesalazine was commenced uneventfully, and subsequently changed to oral mesalazine due to failure to improve.He re-presented 4 days later with frequent rigors, lethargy, palpitations and was generally unwell. His condition settled with conservative management and IV antibiotics.Oral mesalazine was withheld during the first 24 hours but was recommenced on day 2. After 2 doses he developed rigors, pyrexia, tachycardia and vomiting.Oral mesalazine was discontinued thereafter and his condition progressively improved. Mesalazine has not been re-introduced.
Highlights
He re-presented 4 days later with a significant clinical deterioration
He was febrile with frequent rigors, lethargic, complaining of palpitations and sinusitis. He was passing 8-10 stools per day with a significant amount of blood and mucus per rectum. He was on no other medications aside from the oral mesalazine
The rigors and general deterioration developed after the commencement of oral mesalazine
Summary
He re-presented 4 days later with a significant clinical deterioration He was febrile with frequent rigors, lethargic, complaining of palpitations and sinusitis. He was passing 8-10 stools per day with a significant amount of blood and mucus per rectum. He was on no other medications aside from the oral mesalazine. Cases Journal 2009, 2:6715 http://casesjournal.com/casesjournal/article/view/6715 coeliac disease He was a lifelong non-smoker and drank on average 15 units of alcohol per week. He had routine blood tests and blood cultures carried out. Oral mesalazine was not administered during the first 24 hours in hospital but was recommenced on the second day as an in-patient
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