A 34-year-old man with a 2-year history of ulcerative colitis was admitted to a hospital because of severe total colitis. Despite IVH, administration of prednisone and mesalazine and granulocytapheresis (GCAP), bloody diarrhea persisted for about 2 months and he was referred to our hospital. He com-plained of dyspnea, fever up, hypoxicemia and chest x-ray remarkably showed bilateral interstitial pulmonary infiltrates. Pneumonitis due to pneumocystis carinii pneumoniae was diagnosed. He was medicated sulfamethoxazole trimethoprim with a succesful result. Subtotal colectomy, ileostomy and sigmoid-colostomy were made.
Steroids, immunosuppressive drugs and GCAP are often used in the treatment of ulcerative colitis that can cause immunodeficiency with opportunistic infection. It is important to decide to select a surgical treatment before development of the infection when limits of internal treatment are ascertained.