<i>Clostridium difficile</i>Enterocolitis and Reactive Arthritis: A Case Report and Review of the Literature

Cappella, Michela; Pugliese, Fabrizio; Zucchini, A.; Marchetti, Federico

doi:10.1155/2016/1591753

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…The time to presentation from diarrhea to arthritis can be from 1 to 2 weeks 6 up to 4 to 12 weeks. 7 Our patient's CDI occurred 4 weeks prior to ReA. Management includes nonsteroidal anti-inflammatory drugs (NSAIDs), and symptoms most often resolve within 2 to 4 weeks.…”

Section: Documented Anmentioning

confidence: 89%

“…Our study adds to limited pediatric literature, much of which is greater than 10 years old. Across both English and non-English literature that we were able to identify, there are 35 total pediatric cases of CDIAReA reported, among 7 case reports [7][8][9][10][11][12][13] and 1 case-control report including 26 cases. 6 With our report, there are a total number of 36 reported pediatric cases of CDIAReA.…”

Section: Documented Anmentioning

confidence: 99%

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Pediatric Reactive Arthritis Due to Clostridioides difficile Infection

Rand

Yau

et al. 2022

Clin Pediatr (Phila)

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A 7-year-old boy with recent left elbow septic arthritis and osteomyelitis presented with new left knee swelling. The patient was recovering from recurrence of traumainduced left elbow septic arthritis and osteomyelitis, which had resulted in 2 admissions within the preceding 2 months. Approximately 1 month into his antibiotic treatment for these conditions, he had developed Clostridioides difficile (C difficile) enterocolitis and was treated with metronidazole. Presenting symptoms began with left knee pain 3 days prior to presentation, with subsequent redness, swelling, pain, and refusal to ambulate, prompting a visit to the Emergency Department. At this time, he was still completing a 6-week course of cephalexin 3 times daily for prior diagnosis. He had experienced mild back pain for approximately 2 weeks prior to admission but had no other significant musculoskeletal complaints. He had no rashes, no visual symptoms, no urogenital symptoms, and no current complaints of diarrhea, after his C difficile diagnosis and treatment 3 weeks prior.At the Emergency Department, he was afebrile (T 36.7°C), had tachycardia to 125 bpm, with normal respiratory rate (26 bpm), blood pressure (102/77 mm Hg), and oxygen saturating 98% on room air. Physical examination was notable for erythema of the left knee, with warmth, swelling, and tenderness to palpation, as well as a palpable effusion. Patient preferred to keep the left leg flexed at the knee and reported pain with full extension. Neurovascular examination was intact. He had negative examination at all other joints, except his left elbow which showed only mild swelling, but no tenderness or limited range of motion, felt to be secondary to improving previous infection.Diagnostic testing showed evidence of inflammation, with white blood cell (WBC) count of 14 000/uL, elevated platelets to 627 000/uL, erythrocyte sedimentation rate to 60 mm/h, C-reactive protein (CRP) reaching a peak of 15.9 mg/dL. Comprehensive metabolic panel was within normal limits. He was SARS-COv-2 PCR 1098977C PJXXX10.

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Section: Documented Anmentioning

confidence: 89%

Section: Documented Anmentioning

confidence: 99%

Pediatric Reactive Arthritis Due to Clostridioides difficile Infection

Rand

Yau

et al. 2022

Clin Pediatr (Phila)

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Reactive arthritis: an unusual presentation of acuteClostridioides difficilecolitis

et al. 2021

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A 20-year-old Caucasian man with a history of psoriasis presented to the emergency department due to a 2-week history of severe polyarthralgia and a 3-week history of non-bloody diarrhoea. The initial workup 2 days prior in an urgent care clinic returned negative for all enteric pathogens including Clostridioides difficile nucleic acid amplification test. Investigations revealed colitis on CT and pseudomembranous colitis on colonoscopy. The aspirate returned positive for C. difficile toxin. Tissue biopsies of the ascending, transverse, sigmoid colon and rectum were negative for chronicity to suggest inflammatory bowel disease with extraintestinal manifestation as the aetiology of polyarthralgia, which had been the most likely differential diagnosis until that point. The biopsy confirmed the diagnosis of reactive arthritis in the setting of C. difficile colitis. The patient improved on treatment with naproxen and was referred to rheumatology where he was found to be HLA-B27 positive.

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Clostridioides difficile infection in infants: a case report and literature review

Dong

Hao

et al. 2023

Gut Pathog

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Background Clostridioides difficile (C. difficile) is the major pathogen causing antibiotic-associated diarrhea. There are a variety of symptoms associated with C. difficile infection (CDI) in adults, including self-limiting diarrhea, pseudomembranous colitis, toxic megacolon, septic shock, and even death from the infection. However, the infant’s intestine appears to be completely resistant to the effects of C. difficile toxins A and B with rare development of clinical symptoms. Case presentation In this study, we reported a 1-month-old girl with CDI who was born with neonatal hypoglycemia and necrotizing enterocolitis. Her symptom of diarrhea occurred after extensive use of broad-spectrum antibiotics during hospitalization and was accompanied by elevated white blood cell, platelet, and C-reactive protein levels, and repeated routine stool examinations were abnormal. She was recovered by norvancomycin (an analogue of vancomycin) and probiotic treatment. The results of 16 S rRNA gene sequencing also demonstrated the recovery of intestinal microbiota with the enrichment of Firmicutes and Lactobacillus. Conclusions Based on the literature review and this case report, clinicians should also pay attention to diarrhea caused by C. difficile in infants and young children. More strong evidence is needed to explain the true prevalence of CDI in this population and to better understand the C. difficile-associated diarrhea in infants.

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Clostridium difficileEnterocolitis and Reactive Arthritis: A Case Report and Review of the Literature

Cited by 4 publications

References 11 publications

Pediatric Reactive Arthritis Due to Clostridioides difficile Infection

Pediatric Reactive Arthritis Due to Clostridioides difficile Infection

Reactive arthritis: an unusual presentation of acuteClostridioides difficilecolitis

Clostridioides difficile infection in infants: a case report and literature review

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