You are consulted on a 38 yr old man who has been in a motor vehicle accident with traumatic brain injury who is having large volume diarrhea.
The patient was admitted to the MICU after surgery 14 days prior, and has been in a persistent vegetative state. He is being treated with antibiotics for ventilator associated pneumonia (VAP) with Vancomycin/ cefepime and is receiving nutrition via NG tube for a week.
After consultation with his family, a PEG tube was placed endoscopically for nutrition on hospital day # 10.Tube feeds with a standard enteral nutrition formula were started the following day.
Two days later the patient developed 4-5 watery large volume foul smelling stools/ day
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