Clostridium difficile (C. difficile) colitis accounts for nearly 15-20 % of antibiotic-associated diarrhea. Manifestations include asymptomatic carriage, self-limited diarrhea, and pseudomembranous colitis, which is sometimes life-threatening. Despite effective therapy with metronidazole and vancomycin relapse rates are 15-33 %. Although colitis is seen in critically ill patients treated with combinations of broad-spectrum antibiotics, reports describing severe sepsis as a result of C. difficile infection are limited. We describe the case of recurrent severe sepsis due to recurrent local intestinal C. difficile infection as the only identifiable etiology. The mechanism of severe sepsis may be a derangement of the gastrointestinal barrier function. This could result in absorption of microbes or endotoxin or activation of inflammatory cascades in the submucosa of the intestine or liver. In general, for successful treatment of C. difficile infections other than anticlostridial antibiotics should be discontinued. However, in the present case bacterial translocation from the intestine is an attractive explanation for severe sepsis and therefore additional antibiotics had been administered.

Infrared contact coagulation (ICC) was evaluated in 3 different tumor models. 56–94% of all tumor-bearing rats, hamsters or mice were cured by ICC, whereas 100% of the controls died. The possibility that long-lasting immunological resistance might develop against the tumor after ICC was investigated by repeated tumor challenge. Cytotoxicity against tumor cells of host thymocytes and splenocytes following ICC was demonstrated in a Winn assay. The production of a mainly T-cell-dependent immune response could be due to ICC-induced antigenic changes in the tumor cells.

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