[Inflammatory bowel disease and Clostridium difficile: be prepared].
In this report we describe 3 female patients, aged 38, 29 and 91, with inflammatory bowel disease (IBD) and suffering from an episode of abdominal symptoms and diarrhoea. This raised suspicion of a flare-up of IBD, but all three proved to have Clostridium difficile-associated disease (CDAD). This diagnosis led to a change in management, medication being changed from ciprofloxacin into metronidazole in 2 patients. Patients known to have IBD often present with abdominal pain and diarrhoea. In such a situation an exacerbation of the IBD usually seems most likely. However, an infection with C. difficile always has to be considered, since this infection can mimic a flare-up of IBD. There is a rising incidence of C. difficile in patients with IBD. C. difficile infections in IBD-patients tend to run a more severe course. Therefore, early diagnosis of CDAD in IBD patients is important and has distinct therapeutic implications.
Starrenburg-Razenberg
A J Anja
AJ
Sint Franciscus Gasthuis, Rotterdam, Afd. Interne Geneeskunde, the Netherlands. arazenberg@hotmail.com
Koeleman
J G M Hans
JG
van Tilburg
A J P Antonie
AJ
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D000328:Adult; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy; D008795:Metronidazole / Q000627:therapeutic use; D012307:Risk Factors
D000890:Anti-Infective Agents; D008795:Metronidazole