Use of Infliximab as rescue therapy in acute severe Ulcerative Colitis with recent norovirus infection

Background and aims: Norovirus infection is a common cause of acute diarrhoeal illness and may occur in the setting of inflammatory bowel disease. Methods: A patient with an acute severe first presentation of Ulcerative Colitis failed to settle with intravenous steroids and rescue therapy was considered. The isolation of norovirus in his stool caused concern about aggravating the infection if immunosuppression ensued. Following a brief period of watchful waiting and a full discussion between physician, surgeon and patient, Infliximab was administered (5 mg/kg). Results: The patient responded well both clinically and biochemically. Conclusions: In this case, Infliximab was a safe and efficacious intervention in a patient with acute Ulcerative Colitis and recent norovirus infection. (c) 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.