Clostridium difficile infection of the small bowel--two case reports with a literature survey.
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.
Holmer
Christoph
C
Department of General, Vascular and Thoracic Surgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. christoph.holmer@charite.de
Zurbuchen
Urte
U
Siegmund
Britta
B
Reichelt
Ute
U
Buhr
Heinz J
HJ
Ritz
Jörg-Peter
JP
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