ISSN: 2148-4902 | E-ISSN: 2536-4553
Infliximab use in ulcerative colitis flare with clostridium difficile infection: A report of two cases and literature review [North Clin Istanb]
North Clin Istanb. 2018; 5(3): 256-260 | DOI: 10.14744/nci.2017.79446

Infliximab use in ulcerative colitis flare with clostridium difficile infection: A report of two cases and literature review

Bhupinder S. Romana, Abdulmajeed A. Albarrak, Mohamad H. Yousef, Veysel Tahan
Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, Missouri, USA

Clostridium difficile infection (CDI) is a major cause of morbidity and mortality in patients with inflammatory bowel disease (IBD), especially in ulcerative colitis (UC). The incidence and severity of CDI in IBD has shown an increasing trend in the last two decades. Patients with IBD are predisposed to CDI secondary to the recurrent use of antibiotics, corticosteroids, and immunosuppressants and secondary to dysbiosis. It is clinically challenging to distinguish the symptoms of CDI from an IBD flare. The worsening of IBD symptoms demands escalation of steroids or initiation of biologics. However, the management of CDI in IBD, not responding to antibiotics, is not well described beyond a few case reports. We report two cases of CDI with active UC flare. The patients did not respond to antibiotics or intravenous corticosteroids but had rapid resolution of CDI symptoms after receiving infliximab infusion. The optimal dosing and infusion frequency of infliximab in management of CDI in UC/IBD remains to be established.

Keywords: Clostridium difficile, comorbidity; dual; infliximab; tumor necrosis; treatment; ulcerative colitis.

Bhupinder S. Romana, Abdulmajeed A. Albarrak, Mohamad H. Yousef, Veysel Tahan. Infliximab use in ulcerative colitis flare with clostridium difficile infection: A report of two cases and literature review. North Clin Istanb. 2018; 5(3): 256-260

Corresponding Author: Veysel Tahan, United States

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