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Updated: Jul 5, 2026

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Treatment of metronidazole-refractory Clostridium difficile enteritis with vancomycin
Keith E Follmar1, Sara A Condron, Immanuel I Turner
1Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Background:
Clostridium difficile infection of the colon is a common and well-described clinical entity. Clostridium difficile enteritis of the small bowel is believed to be less common and has been described sparsely in the literature.
Methods:
Case report and literature review.
Results:
We describe a patient who had undergone total proctocolectomy with ileal pouch-anal anastomosis who was treated with broad-spectrum antibiotics and contracted C. difficile refractory to metronidazole. The enteritis resolved quickly after initiation of combined oral vancomycin and metronidazole. A literature review found that eight of the fifteen previously reported cases of C. difficile-associated small-bowel enteritis resulted in death.
Conclusions:
It is important for physicians who treat acolonic patients to be aware of C. difficile enteritis of the small bowel so that it can be suspected, diagnosed, and treated.
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