Acute Appendicitis: An Extracolonic Manifestation of Clostridium difficile Colitis

Abstract

The current report is the case of a 30-year-old male patient who presented with symptomatology suggestive of appendicitis. However, careful history-taking and laboratory tests led to the diagnosis of Clostridium difficile colitis, resulting in successful nonsurgical management of this patient. Although both appendicitis and C. difficile colitis are common conditions, they are rarely diagnosed concurrently. This is reflected by paucity of literature describing this manifestation. Given this current presentation, the authors contend that the manifestation of extracolonic colitis within the appendix is possibly underdiagnosed or misdiagnosed as an acute appendicitis and thus potentially results in unnecessary surgical intervention. This report reminds physicians to consider the medical approach to managing acute appendicitis given the possibility of underlying C. difficile colitis as the causative factor.

Clostridium difficile appendicitis in an immunocompromised patient: a case report and review of the literature

“…Acute appendicitis is another one of the rare extracolonic manifestation of CDI as we have described here in our case. From review of the literature, there have been very few reported cases of C. difficile appendicitis [ 4 - 7 ].…”

Extraintestinal Clostridioides difficile Infections: Epidemiology in a University Hospital in Hungary and Review of the Literature

“…It may, however, also cause disease in a variety of other organ systems [10][11][12]. Nevertheless, additional extraintestinal Cd (EID) manifestations have also been described: cellulitis [9], prosthetic and periprosthetic joint infections [11][12][13][14], bone infections [15,16], splenic and cranial involvement in the form of abscess formation [17][18][19], pericarditis [20] and infections of the serous membrane of the pleura [21], while case-report-based evidence for fasciitis necrotisans [22,23], visceral abscesses [18], empyema [24] and appendicitis [25] have also been reported in the literature as uncommon presentations of extraintestinal CDIs. Of these extracolonic infections, most were polymicrobial and commonly involved the enteric flora [9,21].…”