Pseudomembranous colitis after COVID-19 antibacterial therapy

Abstract

A new coronavirus infection poses a challenge to infectious disease specialists, health care administrators, and subspecialty physicians in the search for the most eff ective treatment options. The past year has allowed us to clarify the main aspects of pathogenesis with a focus on the most severe versions of the COVID-19 course. Most signifi cant is to understand that the severe course is associated with prolonged viremia and T-cell lymphocyte defi ciency leading to activation of innate immunity, manifested by a burst of macrophage activity known as the “cytokine storm”. This inadequate response is a major factor in both pulmonary and multiple organ failure. Fever, pulmonary infi ltrates with leukocytosis and neutrophilia are traditionally perceived by doctors as indications for antibiotic therapy, which is nevertheless erroneous in the absence of signs of bacterial infection. We present a case that illustrates the severe course of pseudomembranous colitis and secondary myocarditis in an elderly woman with comorbid pathology and massive antibiotic therapy received during hospitalization for COVID-19.