Campylobacter colitis: Rare cause of toxic megacolon

INTRODUCTION: Campylobacter is the leading cause of bacterial diarrhoeal illness worldwide. Toxic megacolon is a rare but potentially devastating complication. PRESENTATION OF CASE: A 55 year old female with liver cirrhosis, alcoholism and hepatitis C, presented with severe colitis and stool specimen positive for Campylobacter. She developed septic shock, multi-organ dysfunction syndrome and toxic megacolon unresponsive to medical therapy, and underwent a subtotal colectomy with end ileostomy. Despite initial improvement, the patient died on postoperative day 4. DISCUSSION: Early surgical consultation is essential as toxic megacolon may be complicated by perforation or uncontrolled bleeding; progressive colonic dilatation with clinical deterioration is also an important indication for surgery. CONCLUSION: Toxic megacolon should be considered in a patient with Campylobacter colitis who becomes critically unwell. Despite treatment, toxic megacolon is associated with a significant risk of mortality.