Roentgenographic features in antibiotic-associated pseudomembranous colitis.

CASE PRESENTATIONS Case 1 . A 62-year-old woman with diabetes was admitted because of an infected toe. Physical examination was normal except for an ulceration of the left 4th toe. Routine laboratory studies revealed only elevated blood sugar and moderate ketonuria. A roentgenogram of the toe revealed osteomyelitis. The infection improved with clindamycin therapy (300 mg IV, t:d), and the toe was amputated on the 6th day of admission. Five days after initiation of antibiotic therapy the patient developed severe diarrhea and emesis. A barium enema showed mucosal irregularity throughout the entire colon with areas of dissection of barium under pseudomembranes (Figures lA, 1B). Sigmoidoscopy and biopsy confirmed the diagnosis of pseudomembranous colitis. The patient developed pneumonia and myocardial infarction, and died.