Application of Recombinant Human Activated Protein C in Severe Pseudomembranous Colitis-Case Report

Dariusz Onichimowski, Paweł Radkowski, Marcin Mieszkowski and Damian Truszczyński

Clostridium difficile is a common pathogen known to cause colitis and antibiotic-associated diarrhea. Its toxins can lead to pseudomembranous colitis, characterized by persistent, occasionally bloody diarrhea, fever, leukocytosis and hypoalbuminemia. Severe cases may progress to sepsis, necessitating hospitalization and ICU care. This case report aims to describe the management of pseudomembranous colitis, focusing on a patient with severe sepsis, where conventional antibiotic discontinuation is challenging due to the need for appropriate antibiotic therapy. A case of pseudomembranous colitis was presented with severe sepsis in a patient who required continued antibiotic therapy. The patient’s clinical course, diagnostic findings and treatment strategy, including the use of Recombinant Human-Activated Protein C (rhAPC), are detailed. In patients with pseudomembranous colitis complicated by severe sepsis, the decision to discontinue antibiotics must be carefully weighed against the need for effective treatment. The addition of rhAPC to appropriately targeted antibiotic therapy, as recommended by the Surviving Sepsis Campaign in cases of septic shock with organ failure, may offer a valuable therapeutic option due to its anti-inflammatory, antithrombotic and profibrinolytic properties. Further research is needed to determine the optimal management approach in such challenging cases.

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