Clostridium difficile colitis following head and neck surgery. Report of cases

Clostridium difficile, a toxin-producing, gram-positive anaerobe, has been implicated as the causative agent of pseudomembranous colitis, an acute inflammatory bowel disease that generally occurs in association with antimicrobial therapy. This subject has received extensive review in the general surgical, medical, and pediatric literature but has not been specifically addressed in the literature of our specialty. We present the report of four recent cases, including one that progressed to the clinical picture of peritonitis and toxin megacolon. The literature is reviewed regarding presentation, diagnosis, and treatment of C difficile colitis. Familiarity with this disease process may minimize morbidity and prevent disastrous complications following major head and neck surgery.