Pseudomembranous colitis with Clostridium difficile during treatment by moxifloxacine (quinolone)

C. difficile is the most frequently pathogenic agent isolated in colitis associated with antibiotics and pseudomembranous colitis (PMC). C. difficile takes advantage of the disturbance of the intestinal flora to settle.
We report a case of PMC appeared during treatment with moxifloxacine in a pulmonary infection in an emphysematous patient.
The diarrhea is generally benign, but can be severe, with toxic megacolon or even the extreme case of colic perforation.
The diagnosis is based on the research of toxins of C. difficile (A and/or B) in the intestinal stools or liquids (collected at the time of the endoscopic examination) to which is associated the anaerobic culture on selective agar. The reference method is the measurement of the cytotoxic effect of the B-toxin on a cell culture.
Metronidazole or vancomycine constitutes the treatment.
The prevention of relapses is very important, hygiene measures and probiotic agents must be associated to the antibiotic treatment.