Case Report
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World J Gastrointest Surg. Mar 27, 2013; 5(3): 37-42
Published online Mar 27, 2013. doi: 10.4240/wjgs.v5.i3.37
Clostridium difficile enteritis: A report of two cases and systematic literature review
Sean P Dineen, Steven H Bailey, Thai H Pham, Sergio Huerta
Sean P Dineen, Steven H Bailey, Thai H Pham, Sergio Huerta, VA North Texas Healthcare System and UT Southwestern Department of Surgery, University of Texas Southwestern, Dallas, TX 75216, United States
Author contributions: Dineen SP designed the research, analyzed the data, and wrote the manuscript; Bailey SH, Pham TH and Huerta S analyzed the data and provided significant revision of the original manuscript.
Correspondence to: Sean P Dineen, MD, Assistant Professor of Surgery, VA North Texas Healthcare System and UT Southwestern Department of Surgery, University of Texas Southwestern, 4500 S Lancaster Road, Dallas, TX 75216, United States. sean.dineen@utsouthwestern.edu
Telephone: +1-214-8571826 Fax: +1-214-8571891
Received: November 11, 2012
Revised: December 13, 2012
Accepted: December 25, 2012
Published online: March 27, 2013
Processing time: 149 Days and 8.6 Hours
Abstract

Clostridium difficile (C. difficile) is the most common cause of healthcare associated infectious diarrhea. In the last decade, the incidence of C. difficile infection has increased dramatically. The virulence of C. difficile has also increased recently with toxigenic strains developing. C. difficile is generally a disease of the colon and presents with abdominal pain and diarrhea due to colitis. However, C. difficile enteritis has been reported rarely. The initial reports suggested mortality rates as high as 66%. The incidence of C. difficile enteritis appears to be increasing in parallel to the increase in colonic infections. We present two cases of patients who had otherwise uneventful abdominal surgery but subsequently developed C. difficile enteritis. Our literature review demonstrates 81 prior cases of C. difficile enteritis described in case reports. The mortality of the disease remains high at approximately 25%. Early recognition and intervention may reduce the high mortality associated with this disease process.

Keywords: Clostridium difficile; Enteritits; Antibiotics; Colorectal surgery; Nosocomial infection