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Clostridium difficile colitis associated with hemolytic-uremic syndrome.
Charles C Mbonu1, Danielle L Davison, Khaled M El-Jazzar
1Division of Infectious Diseases, George Washington University Medical Center, Washington, DC 20037, USA.
Summary
This case study highlights Clostridium difficile colitis associated with hemolytic-uremic syndrome in an adult. Prompt diagnosis and plasmapheresis led to the patient's recovery, with no relapse observed.
Area of Science:
- Gastroenterology
- Nephrology
- Hematology
Background:
- Clostridium difficile infection (CDI) is a common cause of infectious diarrhea.
- Hemolytic-uremic syndrome (HUS) is a rare but serious complication characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury.
Observation:
- A 46-year-old woman presented with severe vomiting, bloody diarrhea, acute kidney injury, and thrombocytopenia.
- Peripheral blood smear revealed schistocytes, indicative of microangiopathic hemolysis.
- Stool analysis confirmed Clostridium difficile toxin A but was negative for Shiga-like toxin and other enteric pathogens.
Findings:
- The patient was diagnosed with Clostridium difficile colitis complicated by hemolytic-uremic syndrome.
- Treatment with plasmapheresis resulted in clinical improvement and recovery of renal function and platelet count.
- This represents the second reported adult case of CDI-associated HUS.
Implications:
- This case underscores the importance of considering CDI-associated HUS in adults presenting with severe gastrointestinal symptoms and signs of microangiopathic hemolysis and renal failure.
- Early recognition and aggressive management, including plasmapheresis, may improve outcomes in this rare condition.
- Further research is warranted to understand the pathogenesis and optimize treatment strategies for CDI-associated HUS.