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Roy M, Dahal K, Roy AK. Invading beyond bounds: extraintestinal Clostridium difficile infection leading to pancreatic and liver abscesses. BMJ Case Rep 2017; 2017:bcr-2017-220240. [PMID: 28847992 DOI: 10.1136/bcr-2017-220240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Clostridium difficile has become a common healthcare-associated infection over the past few years and gained more attention. C. difficile was estimated to cause almost half a million infections in USA in 2011 and 29 000 died within 30 days of the initial diagnosis. Although colitis due to C. difficile is the most common presentation, there have been reported cases of extraintestinal infections. As per our review of literature, this is the third reported case of liver abscess due to the organism.
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Affiliation(s)
- Moni Roy
- Department of Internal Medicine, OSF Saint Francis Medical Center, Peoria, Illinois, USA
| | - Kumud Dahal
- University of Illinois College of Medicine at Peoria, Section of Infectious Diseases, Peoria, Illinois, USA
| | - Ashish Kumar Roy
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
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Nyc O, Krutova M, Kriz J, Matejkova J, Bebrova E, Hysperska V, Kuijper EJ. Clostridium difficile ribotype 078 cultured from post-surgical non-healing wound in a patient carrying ribotype 014 in the intestinal tract. Folia Microbiol (Praha) 2015; 60:541-4. [PMID: 25935201 DOI: 10.1007/s12223-015-0392-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/02/2015] [Indexed: 11/29/2022]
Abstract
Extra-intestinal infections caused by Clostridium difficile are rare. The risk of extra-intestinal infections associated with C. difficile may be particularly relevant in environments contaminated with C. difficile spores. This paper describes the case of a non-diarrheic patient colonized with C. difficile ribotype 014 in the intestinal tract who developed a post-surgical wound infection by C. difficile ribotype 078. The infection responded to metronidazole administered first intravenously and then orally. This case indicates that C. difficile may not only be related to diarrheic diseases, but also to infections of non-healing wounds, especially in situations when C. difficile is the only isolated pathogen.
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Affiliation(s)
- Otakar Nyc
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Marcela Krutova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic. .,DNA Laboratory, Department of Child Neurology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - Jiri Kriz
- Spinal Cord Unit, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jana Matejkova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Eliska Bebrova
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Veronika Hysperska
- Spinal Cord Unit, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ed J Kuijper
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, Netherlands
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Mattila E, Arkkila P, Mattila PS, Tarkka E, Tissari P, Anttila VJ. Extraintestinal Clostridium difficile Infections. Clin Infect Dis 2013; 57:e148-53. [DOI: 10.1093/cid/cit392] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Deptuła A, Kruszyńska E, Mikucka A, Gospodarek E, Olszewski K, Kruczyński J, Mątewski D. Toxin A-producing Clostridium difficile as an aetiological factor of post-traumatic wound infection. J Med Microbiol 2009; 58:963-964. [DOI: 10.1099/jmm.0.008797-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Clostridium difficile is a well-known cause of hospital-acquired infection such as antibiotic associated diarrhoea or pseudomembranous colitis. Extraintestinal infections caused by this pathogen are described rarely. A case of post-traumatic wound infection caused by C. difficile in an immunocompetent, young and otherwise healthy trauma patient is reported. A 31-year-old female, a car accident victim, was admitted to hospital because of polytrauma. After open reduction and internal fixation of a supracondylar femoral fracture by means of the dynamic condylar screw (DCS) system, a purulent fistula occurred. Microbiological examination of the pus revealed C. difficile as the single aetiological factor of this infection. Empirical antibiotic treatment with cefazoline and metronidazole had been administered right after the surgery, but was found to be ineffective. The strain isolated from the patient was sensitive to most antimicrobials except for clindamycin, and amoxicillin/clavulanic acid was chosen for the guided therapy. Such treatment combined with the removal of the DCS system produced a desirable effect.
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Affiliation(s)
- Aleksander Deptuła
- Department of Microbiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Ewa Kruszyńska
- Department of Microbiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Agnieszka Mikucka
- Department of Microbiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Eugenia Gospodarek
- Department of Microbiology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Krzysztof Olszewski
- Department of Orthopaedics and Traumatology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Jacek Kruczyński
- Department of Orthopaedics and Traumatology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
| | - Dariusz Mątewski
- Department of Orthopaedics and Traumatology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, ul. M. Skłodowskiej-Curie 9, 85094 Bydgoszcz, Poland
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