Abstract
A 60-year-old woman underwent a colectomy for descending colon cancer. Suddenly, on the 3rd postoperative day she developed a high fever and severe abdominal pain without diarrhea. Although there was no evidence of anastomotic leakage, surgery was undertaken because it was suspected. A large amount of watery greenish stool was pooled in the patient's ascending colon, which was very dilated. The stool sample tested positive for Clostridium difficile toxin A/B. Oral metronidazole was not effective, and hence, oral vancomycin was given. Subsequently, due to intraperitoneal abscess formation, percutaneous abscess drainage was performed, and an infusion of vancomycin and meropenem was started. The patient had repeat episodes of relapses and recurrences, but was eventually discharged on the 94th postoperative day. To date, the patient is doing well and has not had any recurrence. Recently, the incidence and severity of C. difficile infection has been increasing worldwide, especially in North America and Europe. In the near future, it could become a major problem in Japan as well. We report this case of C. difficile infection to help clinicians focus on the appropriate use of antibiotics.
