Treatment of metronidazole-refractory Clostridium difficile enteritis with vancomycin. Surg Infect (Larchmt) 2008 Apr;9(2):195-200
Date
04/23/2008Pubmed ID
18426352DOI
10.1089/sur.2006.089Scopus ID
2-s2.0-42449119675 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
BACKGROUND: 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.
METHODS: Case report and literature review.
RESULTS: 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.
CONCLUSIONS: 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.
Author List
Follmar KE, Condron SA, Turner II, Nathan JD, Ludwig KAAuthor
Kirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anti-Bacterial AgentsDrug Resistance, Multiple
Enteritis
Female
Humans
Metronidazole
Middle Aged
Treatment Failure
Vancomycin
