Perforated pseudomembranous colitis in the breast-fed infant.

Pseudomembranous colitis (PMC) is uncommon in the infant and complications requiring surgical intervention are rare. All prior cases have involved the direct administration of antibiotics to the child. A 2-month-old girl required bowel resection for perforation of a thickened and inflamed left colon. Findings were consistent with PMC and the stool was Clostridium difficile toxin positive. The patient was treated with vancomycin and did well. The patient's mother later admitted to self-administration of ciprofloxacin while breast-feeding her infant. Oral doses of this drug are concentrated in breast milk at levels higher than serum. Antibiotics derived from breast milk can cause complicated PMC in the infant. A directed history can establish an early diagnosis and help distinguish PMC from other more common infantile enterocolitides.