Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 3 ( May-June, 2023 ) > List of Articles


A Case Report on Fulminant Clostridium difficile Colitis Managed with Vancomycin Administered through Ileostomy

Faris Hussain, P Shihabudheen, Noushad Babu, Nihal Muhammed, Vivek Prasad, EP Ashique, IP Shahsadhi, FT Shana

Keywords : Clostridium difficile, Ileostomy, Intensive care unit, Vancomycin retention enema, Sepsis

Citation Information : Hussain F, Shihabudheen P, Babu N, Muhammed N, Prasad V, Ashique E, Shahsadhi I, Shana F. A Case Report on Fulminant Clostridium difficile Colitis Managed with Vancomycin Administered through Ileostomy. 2023; 2 (3):66-68.

DOI: 10.5005/jp-journals-11006-0056

License: CC BY-NC 4.0

Published Online: 26-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Clostridium difficile (CDF) is a widespread nosocomial infection, usually presented as diarrhea. In fulminant cases, paralytic ileus is common. In postoperative patients with a functioning ileostomy, it is rare. Here, we describe a patient who was admitted with features of septic shock secondary to ileal obstruction and perforation. Since the patient was in sepsis, not responding to broad-spectrum antibiotics and antifungals, and computed tomography (CT) showed edematous bowel loops, we suspected CDF. Investigations confirmed pseudomembranous enterocolitis and responded to treatment which included oral vancomycin along with intravenous (IV) metronidazole and vancomycin as retention enema through rectum, and ileostomy downwards using Foley's catheter. This case report is a newer insight to prompt decision-making and intervention than those described in the conventional treatment algorithm of Clostridium difficile infection (CDI).

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