Community-Acquired Toxigenic Clostridium Difficile Diarrhoea in the Normoxaemic Elderly Who Have Received No Antimicrobials: Soft Evidence for Ischaemic Colitis?

We report three examples of community-acquired toxigenic Clostridium difficile diarrhoea in elderly patients who had neither received antimicrobial therapy nor been institutionalised. These cases stimulated interest in the non-antimicrobial changes which might predispose the host to C. difficile-related disease and raised the spectre of bowel ischaemia as a possible aetiological factor.