title: Unusual localization of clostridium difficile infection in an isolated segment of the descending colon in a critical care patient.
abstract: Unrecognized severe pseudomembranous colitis may become life threatening. A typical Clostridium difficile infection is associated with involvement of the colon; however, small bowel disease has also been described. Here, we present a case of a 48-year-old man with Clostridium difficile colitis of an isolated segment in the descending colon treated by a novel catheter intraluminal antibiotic irrigation. The intraluminal antibiotic irrigation was performed through a Foley catheter inserted into the isolated mucus fistula. The patient recovered after three weeks of intraluminal vancomycin (250 mg diluted in 150 ml of normal saline  x Q6) and metronidazole (500 mg  x Q8). Both antibiotics were given into the mucus fistula over 30 min. The patient was discharged from the unit four weeks after admission. This novel technique, in which the antibiotic was administered through an inserted intraluminal Foley urinary catheter, may be an efficient and safe alternative when conventional routes cannot be implemented.
authors: Department of Anesthesiology and Critical Care, Soroka Medical Center, Ben-Gurion University of the Negev, 84105 Beer Sheva, Israel.
authors: Evgeni
authors: E
authors: Brotfain
authors: Leonid
authors: L
authors: Koyfman
authors: Amit
authors: A
authors: Frenkel
authors: Jochanan G
authors: JG
authors: Peiser
authors: Abraham
authors: A
authors: Borer
authors: Benjamin F
authors: BF
authors: Gruenbaum
authors: Alexander
authors: A
authors: Zlotnik
authors: Moti
authors: M
authors: Klein