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P387 Clostridium difficile severe infection in a newborn
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P387 Clostridium difficile severe infection in a newborn
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P387 Clostridium difficile severe infection in a newborn
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Journal Article
P387 Clostridium difficile severe infection in a newborn
2019
Overview
Clostridium difficile infection is a rare event in newborn. Since several studies show a high rate of asymptomatic neonatal colonization by non-toxigenic Clostridium strains, C. difficile is usually not searched in infants and children affected by bloody diarrhea and younger than 12 months. Nevertheless, Clostridium difficile infection should be suspected in patients with bloody diarrhea and other comorbidities. The long term hospitalization and the prolonged exposure to broad-spectrum antibiotic therapy, are also important risk factors for intestinal infection. We present the case of a 10-day newborn with thrombocytopenia associated with rectorrhagia and positivity of inflammation indices. Transfusion of platelets and immunoglobulins was performed with platelet normalization and empiric antibiotic therapy was practiced (ampicillin and gentamicin). A sudden clinical worsening occurred after ten day: he developed severe bloody diarrhea with systemic failure. Laboratory tests showed: neutrophilic leukocytosis,thrombocytosis, anemia, an important increase in inflammation indices. Several abdomen X-ray showed moderate gaseous distension of some intestinal loops with presence of hydroaerial levels. Abdominal ultrasound revealed diffuse thickening of the colon walls (a sign of colitis). The search of C. difficile in stools sample was positive for C. difficile producer of Toxin A and toxin B Enzym Immunoassay (EIA). The infant was successfully treated with vancomycin and metronidazole, without relapsing.
