Cloxacillin: A New Cause of Pill-Induced Esophagitis

A large variety of medications can cause pill-induced esophagitis. Herein we present a case of cloxacillin-induced esophagitis. A 66-year-old male presented with an acute onset of epigastric and retrosternal pain on the 5th day of a course of oral cloxacillin prescribed for erysipelas. Initial clini...

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Main Authors: Petros Zezos, Ziv Harel, Fred Saibil
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Canadian Journal of Gastroenterology and Hepatology
Online Access:http://dx.doi.org/10.1155/2016/2904256
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author Petros Zezos
Ziv Harel
Fred Saibil
author_facet Petros Zezos
Ziv Harel
Fred Saibil
author_sort Petros Zezos
collection DOAJ
description A large variety of medications can cause pill-induced esophagitis. Herein we present a case of cloxacillin-induced esophagitis. A 66-year-old male presented with an acute onset of epigastric and retrosternal pain on the 5th day of a course of oral cloxacillin prescribed for erysipelas. Initial clinical and imaging assessment was negative and he was sent home. A few days later, he returned with persistent severe retrosternal pain; endoscopy at the same day revealed a normal upper esophagus, several small stellate erosions in the midesophagus, and a normal squamocolumnar junction with a small hiatus hernia. Treatment with esomeprazole 40 mg bid and MucaineR suspension resulted in complete resolution of his symptoms. Pill-induced esophagitis may be underreported by patients, when symptoms are mild and unrecognized and/or underdiagnosed by the clinicians as a cause of retrosternal pain, odynophagia, or dysphagia. Failure of early recognition may result in unnecessary diagnostic investigations and prolongation of the patient’s discomfort. This case signifies the importance of enhancing clinician awareness for drug-associated esophageal injury when assessing patients with retrosternal pain, as well as the value of prophylaxis against this unpleasant condition by universally recommending drinking enough water in an upright position during ingestion of any oral medication.
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spelling doaj-art-5f1f226744ed4d13aa4ba06aa8f79bae2025-02-03T06:15:14ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972016-01-01201610.1155/2016/29042562904256Cloxacillin: A New Cause of Pill-Induced EsophagitisPetros Zezos0Ziv Harel1Fred Saibil2Division of Gastroenterology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, CanadaDivision of Nephrology, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, ON, CanadaDivision of Gastroenterology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, CanadaA large variety of medications can cause pill-induced esophagitis. Herein we present a case of cloxacillin-induced esophagitis. A 66-year-old male presented with an acute onset of epigastric and retrosternal pain on the 5th day of a course of oral cloxacillin prescribed for erysipelas. Initial clinical and imaging assessment was negative and he was sent home. A few days later, he returned with persistent severe retrosternal pain; endoscopy at the same day revealed a normal upper esophagus, several small stellate erosions in the midesophagus, and a normal squamocolumnar junction with a small hiatus hernia. Treatment with esomeprazole 40 mg bid and MucaineR suspension resulted in complete resolution of his symptoms. Pill-induced esophagitis may be underreported by patients, when symptoms are mild and unrecognized and/or underdiagnosed by the clinicians as a cause of retrosternal pain, odynophagia, or dysphagia. Failure of early recognition may result in unnecessary diagnostic investigations and prolongation of the patient’s discomfort. This case signifies the importance of enhancing clinician awareness for drug-associated esophageal injury when assessing patients with retrosternal pain, as well as the value of prophylaxis against this unpleasant condition by universally recommending drinking enough water in an upright position during ingestion of any oral medication.http://dx.doi.org/10.1155/2016/2904256
spellingShingle Petros Zezos
Ziv Harel
Fred Saibil
Cloxacillin: A New Cause of Pill-Induced Esophagitis
Canadian Journal of Gastroenterology and Hepatology
title Cloxacillin: A New Cause of Pill-Induced Esophagitis
title_full Cloxacillin: A New Cause of Pill-Induced Esophagitis
title_fullStr Cloxacillin: A New Cause of Pill-Induced Esophagitis
title_full_unstemmed Cloxacillin: A New Cause of Pill-Induced Esophagitis
title_short Cloxacillin: A New Cause of Pill-Induced Esophagitis
title_sort cloxacillin a new cause of pill induced esophagitis
url http://dx.doi.org/10.1155/2016/2904256
work_keys_str_mv AT petroszezos cloxacillinanewcauseofpillinducedesophagitis
AT zivharel cloxacillinanewcauseofpillinducedesophagitis
AT fredsaibil cloxacillinanewcauseofpillinducedesophagitis