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Clostridium difficile brain empyema after prolonged intestinal carriage
J Gravisse1, G Barnaud, B Hanau-Berçot
1Service of Bacteriology-Virology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Journal of Clinical Microbiology
|January 9, 2003
Summary
Clostridium difficile can cause brain empyema, even when nontoxigenic strains are present in the gut. Identical nontoxigenic C. difficile strains were found in both the intestine and brain abscess.
Area of Science:
- Microbiology
- Infectious Diseases
- Neurology
Background:
- Clostridium difficile is a common cause of antibiotic-associated diarrhea.
- Extraintestinal C. difficile infections are rare and typically occur in polymicrobial settings.
Observation:
- A case of brain empyema is presented.
- The empyema occurred following recurrent intestinal carriage of a nontoxigenic Clostridium difficile strain.
Findings:
- Brain abscess cultures revealed both toxigenic and nontoxigenic C. difficile isolates.
- Pulsed-field gel electrophoresis confirmed that nontoxigenic C. difficile strains from the intestine and brain were genetically identical.
Implications:
- This case highlights the potential for nontoxigenic Clostridium difficile strains to be involved in severe extraintestinal infections.
- It suggests a possible pathway for C. difficile translocation from the gut to the central nervous system.
- Further research is needed to understand the mechanisms and risk factors associated with C. difficile brain infections.