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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Intravenous immunoglobulin in treatment of Clostridium difficile colitis
  1. Lokesh Shahani1,
  2. Janak Koirala2
  1. 1Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  2. 2Division of Infectious Diseases, Southern Illinois University School of Medicine, Springfield, Illinois, USA
  1. Correspondence to Dr Lokesh Shahani, lokesh83{at}


Clostridium difficile infection is the most common infectious cause of healthcare-acquired diarrhoea. Severe infections cause therapeutic challenges for healthcare providers. Various novel treatment modalities are currently being explored for treatment of severe disease. The authors report a 70-year-old female who presented to the emergency room with 1 week history of fever, watery diarrhoea, diffuse abdominal pain and weakness. C difficile toxin was detected in the stool and abdominal CAT scan showed extensive colonic wall thickening. The patient was started on intravenous metronidazole along with oral vancomycin. Due to the severity of the infection the patient was given intravenous immunoglobin for 4 consecutive days. The patient had vast improvement in her clinical symptoms with resolution of the multi-organ system failure. It is currently considered that the predominant intravenous immunoglobin’s mechanism of action is through binding and neutralisation of toxin A by IgG antitoxin A antibodies.

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  • Competing interests None.

  • Patient consent Obtained.