Recurrent septicemia with lethal outcome during and after cyclosporine therapy in severe ulcerative colitis

High dose corticosteroids have been the mainstay in the treatment of fulmin ant ulcerative colitis (UC) for a long time. In the last years intravenous cyclosporine (CyA) has been reported to be rapidly effective and relatively safe in patients with severe corticosteroid-resistent UC. We report on a 6 4 year old patient with a severe flare-up of UC who responded well to intra venous CyA after a standard therapy with high dose corticosteroids alone ha d been ineffective. However, recurrent staphylococcus aureus sepsis develop ed during CyA therapy. Despite a long-time antibiotic therapy two further e pisodes of staphylococcus aureus sepsis occurred after discontinuation of C yA treatment. Being in remission with his UC the patient died 14 months lat er of staphylococcus aureus sepsis despite intense antibiotic treatment. In fectious complications of this therapeutic regime in severe UC are known bu t to our knowledge a recurrent sepsis complicating this therapy even after cessation of CyA has not been reported in the literature so far.