Background: The overall incidence of Clostridium difficile infection (CDI) is higher among patients with inflammatory bowel disease (IBD). The nature of this disease association is unknown but likely involves an altered gut microbiome and impaired host immune responses. Studies on CDI in IBD patients have yielded variable and conflicting results on outcome measures such as [...]

Case Presentation: A 58 year-old Caucasian female presented with a history of painful lesions of the gluteal, perineal, and vulvar areas. These lesions had been progressive with worsening drainage and scar formation over the last decade. She was treated with multiple antibiotics and antifungals in the past without improvement. No lesions were seen in her axilla. [...]

Case Presentation: A 55-year-old woman, with benign past medical history presented with a two-week of low-grade fevers and erythematous papules that evolved into small discrete honey-colored crusted plaques and pustules on her face. She was initially treated with antibiotics for presumed bacterial infection. She had been on Doxycycline for over a week for management of [...]

Case Presentation: A 56 year-old woman with well-controlled peri-rectal Crohn’s disease on infliximab presented to the hospital for management of a 2.5 year history of painful, draining vulvar dermatitis that had been biopsied twice and showed lichen simplex chronicus. Prior therapies included topical steroids and multiple antibiotic courses without significant or sustained improvement. MRI to [...]

Case Presentation: A 23-year-old man with no past medical history presented with 3-days of severe abdominal pain, nausea, vomiting and alternating episodes of constipation and watery diarrhea. He reported 2-year history of intermittent episodes of dark and blood-streaked bowel movements. He had no tobacco smoking, alcohol or recreational drug use history. Vital signs revealed temperature [...]

Case Presentation: A 59 y/o male who presented to the hospital with a 2 week history of subjective fevers, generalized fatigue, and non-bloody diarrhea. Past medical history was notable for indeterminate ulcerative colitis (UC) and was being managed with azathioprine and mesalamine. He was recently prescribed antibiotics and developed diarrhea shortly after. He denied any [...]

Case Presentation: A 62-year-old male patient with a history of heart transplant nine years ago on mycophenolate mofetil (MMF) presented for chronic diarrhea with increasing frequency, urgency, incontinence, sporadic melena, and fevers. He tested positive for Clostridium difficile (C. diff) toxin and improved on fidaxomicin. Soon after discharge, he required rehospitalization for worsening symptoms. A [...]

Case Presentation: A 21-year-old male with past medical history of Crohn’s disease on monthly infliximab infusion initially presented to the emergency department with a 5-day history of joint pain. He first noted left-sided pain that was only relieved by heat, but it progressed to left hip and groin pain made worse with movement. The patient [...]

Case Presentation:  A 35 year-old Chinese male with a known history of Crohn’s disease was diagnosed in 2014 and treated with nine doses of infliximab. He had normalization of his colon on follow up colonoscopy, but without complete resolution of the patient’s symptoms.  He was started on azathioprine and his symptoms worsened. Repeat colonoscopy showed [...]

Case Presentation: A 54-year-old Japanese man presented to his primary care physician with a 3-month history of epigastric pain, fever, and unintentional weight loss. Upper endoscopy showed only a gastric polyp. Abdominal computed tomography showed small intestinal dilatation accompanied by adhesion to the sigmoid colon, and perianal abscess. Crohn’s disease was suspected and he was [...]