During a four-year period we encountered 16 patients with colitis following oral lincomycin therapy. All patients were afebrile, had normal or mildly elevated white blood cell counts, and recovered completely following withdrawal of the drug or withdrawal and short-term topical steroid therapy (enema or suppository).
The colitis was indistinguishable by history and sigmoidoscopy from mild to moderately severe colitis of other types. Biopsy specimens demonstrated marked mucosal edema, patchy subepithelial hemorrhage, and moderate inflammation of the lamina propria. Electron microscopy of two biopsy specimens showed severe damage to surface epithelium. Reversible drug-induced mucosal disease should be considered in the differential diagnosis of patients with colitis who have a history of recent antibiotic therapy.