Treatment of metronidazole-refractory Clostridium difficile enteritis with vancomycin

Keith E. Follmar, Sara A. Condron, Immanuel I. Turner, Jaimie D. Nathan, Kirk A. Ludwig

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalSurgical infections
Issue number2
StatePublished - Apr 1 2008
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Microbiology (medical)
  • Infectious Diseases


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