Treatment of metronidazole-refractory Clostridium difficile enteritis with vancomycin

Surgical Infections
Keith E FollmarKirk A Ludwig

Abstract

Clostridium difficile infection of the colon is a common and well-described clinical entity. Clostridium difficile enteritis of the small bowel is believed to be less common and has been described sparsely in the literature. Case report and literature review. We describe a patient who had undergone total proctocolectomy with ileal pouch-anal anastomosis who was treated with broad-spectrum antibiotics and contracted C. difficile refractory to metronidazole. The enteritis resolved quickly after initiation of combined oral vancomycin and metronidazole. A literature review found that eight of the fifteen previously reported cases of C. difficile-associated small-bowel enteritis resulted in death. It is important for physicians who treat acolonic patients to be aware of C. difficile enteritis of the small bowel so that it can be suspected, diagnosed, and treated.

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Citations

Jul 16, 2010·International Journal of Colorectal Disease·Christoph HolmerJörg-Peter Ritz
Feb 7, 2009·Gastroenterology Research and Practice·Elena Boland, Jon S Thompson
Apr 3, 2009·Gut Pathogens·Udayakumar Navaneethan, Ralph A Giannella
Mar 13, 2014·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·S KilleenD C Winter
May 17, 2011·Gastroenterología y hepatología·Antonio Ramos MartínezAngel Asensio Vegas
Nov 18, 2014·Inflammatory Bowel Diseases·Darren N Seril, Bo Shen
Apr 5, 2013·World Journal of Gastrointestinal Surgery·Sean P DineenSergio Huerta
Jul 6, 2014·The American Journal of Gastroenterology·Darren N Seril, Bo Shen
Dec 23, 2009·Scandinavian Journal of Gastroenterology·Saif MusaTony Rahman
Apr 1, 2020·American Journal of Physiology. Gastrointestinal and Liver Physiology·Melinda A EngevikJames Versalovic

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