Isolated Clostridium difficile Small Bowel Enteritis in the Absence of Predisposing Factors

Background:Clostridium difficile colitis is a growing problem as antibiotic use and resistance continues to plague healthcare, yet few articles documenting the occurrence and outcomes of C. difficile small bowel enteritis exist. We believe to have the first reported case of C. difficile enteritis originating in the small bowel, in absence of any previously reported risk factors for this rare infection with high mortality. Case Presentation: A 71-year-old female presenting with bowel obstruction and strangulation was found to have C. difficile enteritis after bowel resection and discontinuity that was found repeatedly to be isolated to the small bowel despite an intact, healthy colon. Conclusion: The possibility of small bowel C. difficile in surgically manipulated small bowel is real, even in the absence of long-term antibiotic use, inflammatory bowel disease, or immunodeficiency and with a normal colon in place. This is an entity not described previously and further expands the potential impact of this ubiquitous bacterium.