Intest Res  
Enteric infections complicating ulcerative colitis
Dejan Micic1, Ayal Hirsch1, Namrata Setia2, David T. Rubin1
1Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine and 2Department of Pathology, University of Chicago, Chicago, IL, USA
Correspondence to: Dejan Micic, Section of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, University of Chicago Medical Center, University of Chicago, 5841 S. Maryland Ave., MC 4076, Room M421, Chicago, IL 60637, USA. Tel: +1-773-702-1000, Fax: +1-773-834-4037, E-mail: dmicic@medicine.bsd.uchicago.edu
Received: October 4, 2017; Revised: April 30, 2018; Accepted: May 10, 2018; Published online: July 11, 2018.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Enteric infections have previously been postulated to play a role in the pathogenesis of inflammatory bowel disease (IBD), however, little evidence exists in the etiologic role of specific enteric infections in the development of IBD. When encountered in the setting of IBD, enteric infections pose a clinical challenge in management given the competing treatment strategies for infectious conditions and autoimmune disorders. Here we present the case of a young male with enteric infections complicating a new diagnosis of IBD. Our patient’s initial clinical presentation included diagnoses of Klebsiella oxytoca isolation and Clostridium difficile infection. Directed therapies to include withdrawal of antibiotics and fecal microbiota transplantation were performed without resolution of clinical symptoms. Given persistence of symptoms and active colitis, the patient was diagnosed with ulcerative colitis (UC), requiring treatments directed at severe UC to include cyclosporine therapy. The finding of multiple enteric infections in a newly presenting patient with IBD is an unexpected finding that has treatment implications.
Keywords: Inflammatory bowel diseases; Clostridium difficile; Colitis, ulcerative


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