Objectives: Small intestinal bacterial overgrowth (SIBO) is challenging to treat and diagnose and is associated with diagnosisof irritable bowel syndrome (IBS). Although no FDA-approved medications exist for treatment of SIBO, rifaximin has recentlyreceived approval to treat diarrhea-predominant IBS and patients with methane-positive SIBO breath tests. The aim of thisstudy is to evaluate patient response to rifaximin for SIBO based on breath test results. Materials and methods: All patientsunderwent breath testing to evaluate for SIBO during a 42-month period. Patients were defined as having a positive glucosebreath test for SIBO based on an increase of ≥ 20 ppm of hydrogen and/or ≥ 10 ppm of methane 90 minutes after ingestingglucose. Patient demographic and symptom data, antibiotic treatment regimens, symptomatic response to therapy, and repeattreatments were recorded. Institutional...

Clostridium difficile is a major cause of antibiotic-associated diarrhea. We report a patient with complicated Clostridium difficile infection (CDI) who developed rapidly progressive acute respiratory distress syndrome (ARDS), for which CDI was the only identifiable source. CDI should be considered in the differential diagnosis for anyone with diarrhea who presents ARDS, especially in high-risk groups such as the elderly, hospitalized patients, or those who have had a history of CDI.