The impact of Clostridium difficile on paediatric surgical practice: a systematic review

Laughlin, Danielle Mc; Friedmacher, Florian; Puri, Prem

doi:10.1007/s00383-014-3543-5

Cited by 15 publications

(8 citation statements)

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“…Weiterhin findet sich eine CDI signifikant häufiger bei Patienten mit onkologischen Erkrankungen, nach Stammzelltransplantation oder solider Organtransplantation [59,60]. Zusätzlich gibt es Fallberichte zu schweren Verläufen einer CDI bei Patienten mit Mukoviszidose [65,66] und bei Morbus Hirschsprung [67].…”

Section: I31 Statementunclassified

“…Entscheidende Determinante für den Nachweis von Clostridien im Darm von Frühgeborenen ist die Zeitdauer des Aufenthalts auf der Intensivstation[97]. Trotz der hohen Rate asymptomatischer Träger von C. difficile bei Säuglingen kann C. difficile eine Ursache für eine besonders schwer verlaufende Kolitis bei M. Hirschsprung sein[67].Exazerbationen chronisch-entzündlicher Darmerkrankungen sind auch im Kindesalter mit CDI assoziiert[64,[98][99][100].Tests auf C. difficile sollten nur bei symptomatischen Patienten mit klinisch signifikanten wässrigen Durchfällen erfolgen, wenn es Verdacht auf eine CDI gibt oder prädisponierende Faktoren dafür vorliegen. Bei Säuglingen sollten Tests auf C. diff.…”

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S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

et al. 2019

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Leitlinie der Gesellschaft für pädiatrische Gastroenterologie und Ernährung (GPGE) gemeinsam mit der Deutschen Gesellschaft für Kinder-und Jugendmedizin (DGKJ), dem Berufsverband der Kinder-und Jugendärzte (BVKJ), der Deutschen Gesellschaft für pädiatrische Infektiologie (DGPI), der österreichischen Gesellschaft für Kinder-und Jugendheilkunde (ÖGKJ), der Deutschen Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselstörungen (DGVS), dem Arbeitskreis "Krankenhaus & Praxishygiene" der AWMF und der Deutschen Gesellschaft für Pflegewissenschaft e. V. (DGPW)

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Section: I31 Statementunclassified

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S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

et al. 2019

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“…[ 18] There was insufficient data to analyze the role of other pathogens. One retrospective study found 58% of patients with HAEC had a cow's milk allergy.…”

Section: Infectionmentioning

confidence: 99%

Identifying Information Needs for Hirschsprung Disease Through Caregiver Involvement via Social Media: A Prioritization Study and Literature Review (Preprint)

Wittmeier¹,

Hobbs-Murison²,

Holland³

et al. 2018

Preprint

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“…Thus, refractory constipation may be associated with future risk of C. difficile toxic megacolon. 1 More than 90% of patients with C. difficile infection clinically present with watery or bloody diarrhoea 2. To our knowledge, there is only one case report of an adult patient with C. difficile infection who presented with constipation 3…”

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confidence: 99%

PaediatricClostridium difficilepseudomembranous colitis: a complication of refractory constipation?

et al. 2018

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DesCripTionA 14-year-old girl presented to the emergency department with a 1-week history of a lack of bowel movements, intermittent fevers, malaise and fatigue, for which she only took antipyretics. She also had a 1-month history of diffuse abdominal pain, abdominal distention (predominantly on the lower abdomen), decreased appetite, and a 1.5 kg weight loss. She had a history of chronic constipation and daily faecal incontinence since she was 8 years old, which was inconsistently treated with unspecific laxatives and weekly enemas. There was no history of hospitalisation or medication use (antibiotics, Proton Pump Inhibitors or steroids) during the 6 months prior to presentation.On admission, the temperature was 38.2°C; heart rate was 84 beats per minute; respiratory rate was 24 breaths per minute; and blood pressure measured 90/90 mm Hg (systolic pressure <5th percentile). Her height was 155 cm (38th percentile), weight was 32 kg (2th percentile) and body mass index was 13.3 (percentile 0). On physical examination she appeared toxic and wasted; conjunctival and generalised paleness were noted. The abdomen appeared significantly distended, and auscultation revealed decreased bowel sounds. A mass was palpated on the left lower quadrant, consistent with faecal matter in the rectum. Peritoneal signs were absent. Digital rectal examination revealed abundant faecal matter in the rectum. Mild pedal oedema was noted. The rest of examination was normal. Initial abdominal radiographs showed significant colonic distention and abundant faecal matter in the descending colon and rectum (figure 1). Initial laboratory tests were the following: leukocytes: 16.9 10 3 /µL (4.5-13.5); neutrophils: 82% (36.3-75.5); erythrocytes: 3.48 10 6 /µL (4.1-5.9); haemoglobin: 9.7 g/dL (10.9-15.7); haematocrit: 30% (36-45); reticulocytes: 2.7%; platelets 810 10 3 /µL (170-450); sodium:133 mmol/L (138-145); gamma glutamyl transpeptidase: 42 UI/L (14-26); total proteins: 3.5 g/dL (6.3-8.6); albumin: 1.2 g/d (3.2-4.5). The rest was within normal limits. The patient was diagnosed with severe malnutrition, toxic megacolon and faecal impaction. She was admitted for further management. Enemas, intravenous fluids and empirical antibiotics (ceftriaxone and metronidazole) were initiated. She was kept nil per os. During hospitalisation, urine and blood cultures did not grow pathogens; viral panel was negative; and faecal PCR was positive for Clostridium difficile. The colonoscopy showed signs of pseudomembranous colitis in the sigmoid and descending colon (figure 2). The biopsies confirmed the diagnosis of pseudomembranous colitis (figure 3). Ceftriaxone was discontinued, and metronidazole (30 mg/kg three times a day) was continued to complete a 10-day course. She remained stable during hospitalisation and was discharged due to clinical improvement with a double oral constipation therapy (Polyethylene Glycol 3355 34 g q24, and senna 8.6 mg twice daily). The patient improved significantly in the following months.We hypothesise that patients with refrac...

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The impact of Clostridium difficile on paediatric surgical practice: a systematic review

Cited by 15 publications

References 94 publications

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

S2k-Leitlinie „Akute infektiöse Gastroenteritis im Säuglings-, Kindes- und Jugendalter“ – AWMF Registernummer 068-003

Identifying Information Needs for Hirschsprung Disease Through Caregiver Involvement via Social Media: A Prioritization Study and Literature Review (Preprint)

PaediatricClostridium difficilepseudomembranous colitis: a complication of refractory constipation?

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