A 30-year-old male two years postoperative after total abdominal colectomy with ileoanal anastomosis reports a sudden increase in stool frequency, nocturnal leakage, and low-grade fevers. Physical examination is unremarkable. Flexible endoscopic examination of the small intestinal pouch reveals a friable erythematous mucosa. Biopsies of the mucosa are obtained. While awaiting biopsy results, which of the following is the most appropriate empiric therapy?
A. Oral corticosteroids
B. Oral vancomycin
C. Oral metronidazole
D. Corticosteroid enema
Answer:C
A 30-year-old male two years postoperative after total abdominal colectomy with ileoanal anastomosis reports a sudden increase in stool frequency, nocturnal leakage, and low-grade fevers. Physical examination is unremarkable. Flexible endoscopic examination of the small intestinal pouch reveals a friable erythematous mucosa. Biopsies of the mucosa are obtained. While awaiting biopsy results, which of the following is the most appropriate empiric therapy?
A. Oral corticosteroids B. Oral vancomycin C. Oral metronidazole D. Corticosteroid enema