Case Report
Copyright ©2010 Baishideng Publishing Group Co.
World J Gastrointest Oncol. Oct 15, 2010; 2(10): 390-394
Published online Oct 15, 2010. doi: 10.4251/wjgo.v2.i10.390
Table 1 Comparison of four patients with taxane-associated colitis
Case 1Case 2Case 3Case 4
Age (yr), Sex83, male47, male41, female55, female
DiagnosisAdenocarcinoma of the pancreasAdenocarcinoma of the lungInvasive ductal carcinoma of the breastInvasive ductal carcinoma of the breast
Chemotherapy (all were 21-d cycles)Docetaxel 30 mg/m2 Day 1 & 8 Capecitabine 1600 mg/m2 days 1-14Docetaxel 70 mg/m2 day 1 Carboplatin AUC 6 day 1Docetaxel 70 mg/m2 day 1 Cisplatin 70 mg/m2 day 1Docetaxel 70 mg/m2 day 1 Cyclophosphamide 600 mg/m2 day 1
Clinical presentationSevere bloody diarrhea and dehydration on cycle 1 day 8Severe bloody diarrhea, febrile neutropenia and diffuse abdominal pain on cycle 3 day 10Severe diarrhea positive for occult blood, abdominal pain, and leukocytosis on cycle 2 day 9Severe abdominal pain with guarding on cycle 1 day 9
Antibiotic exposureNoNoNoNo
C. difficile toxinNegative (3 samples)Positive (2 of 3 samples)Negative (3 samples)Not performed
Endoscopic findingsPseudomembranes in the rectum, sigmoid and descending colonPseudomembranes in the sigmoid and descending colonModerate to severe mucosal inflammation of the sigmoid and the rectum with diffuse subepithelial hemorrhagesEndoscopy not performed. Laparotomy revealed sigmoid perforation with peritonitis
TreatmentOral vancomycinIV metronidazole and oral vancomycinOral metronidazoleSurgical resection of affected colonic segment
OutcomeSymptoms resolvedSymptoms resolvedSymptoms resolvedDeveloped postoperative intra-abdominal abscess which was drained and subsequently recovered fully