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The article presents a report on the first recognised case of Clostridium difficile PCR ribotype 027 acquired in Melbourne, Victoria in February 2010. It describes the clinical record of an 83-year-old Latvian man who underwent an aortic valve replacement for aortic stenosis. It discusses the first epidemic strain of this type as a cause of hospital outbreaks in Quebec in 2005 and across North America since 2000, spreading to Europe, Asia and Central America. It recommends metronidazole for mild to moderate cases and oral vancomycin for severe infection.