Intravenous immunoglobulin for recurrent Clostridium difficile diarrhoea

Case No 1 A 77 year old female with chronic obstructive pulmonary disease (COPD), heart failure, and non-insulin dependent diabetes mellitus (NIDDM) developed C difficile diarrhoea after treatment for pneumonia with ceftriaxone and clarithromycin. Leung et al successfully treated five children with recurrent C difficile with immunoglobulin, 3 and there is a single report of success in an adult with recurrent C difficile diarrhoea. 4 Intravenous immunoglobulin has also been effective in two adult patients with severe acute refractory rather than recurrent disease. 5 Normal pooled human immunoglobulin preparations contain significant titres of anti-C difficile antibodies. 5 Although the number of reported patients is still small, it seems that immunoglobulin may be helpful for recurrent C difficile.