title: Clostridium difficile infection of the small bowel--two case reports with a literature survey.
abstract: BACKGROUND
  Diseases associated with Clostridium difficile range from antibiotic-related diarrhea to pseudomembranous enterocolitis, and are serious nosocomial infections with high morbidity and mortality. The C. difficile infection has thus far been regarded as a disease typically affecting the colon. However, the literature contains an increasing number of reports describing infections of the small bowel with fulminant clinical courses and high mortality rates of 60-83%. We think this situation is not very well known.
  
  
  METHODS
  We present two cases of confirmed C. difficile enteritis and a survey of the literature.
  
  
  CONCLUSIONS
  C. difficile enteritis is characterized by a rising incidence, a sometimes fulminant clinical course, and high mortality rates. Early diagnosis of the disease by toxin detection and endoscopy is of paramount importance and can play a substantial role in improving outcomes.
authors.affiliation: Department of General, Vascular and Thoracic Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. christoph.holmer@charite.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Holmer
authors.forename: Urte
authors.initials: U
authors.lastname: Zurbuchen
authors.forename: Britta
authors.initials: B
authors.lastname: Siegmund
authors.forename: Ute
authors.initials: U
authors.lastname: Reichelt
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Jörg-Peter
authors.initials: JP
authors.lastname: Ritz
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000502:physiology*; D003015:Clostridium Infections / Q000382:microbiology / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007082:Ileum / Q000382:microbiology / Q000473:pathology; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology; D007421:Intestine, Small / Q000382:microbiology* / Q000473:pathology*; D008297:Male