Clostridium difficile enteritis in a patient after total proctocolectomy

Summary

Clostridium difficile infection is associated with antibiotic therapy and usually limited to the colonic mucosa. However, it is also a rare cause of enteritis, with only a few cases reported in the literature. In the present report, the case of a 30-year-old woman with Clostridium difficile enteritis who previously had a panproctocolectomy with end ileostomy for severe ulcerative colitis is described. Previously reported cases of Clostridium difficile enteritis are also reviewed. Previous antibiotic therapy had been present in all cases and appears causative, major colonic resection is a precipitating factor. Small bowel Clostridium difficile infection should be considered in any patient with ileostomy flux/diarrhoea after major colonic surgery. If recognised early and treated aggressively the high mortality associated with Clostridium difficile enteritis may be avoided.