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Perforated pseudomembranous colitis in the breast-fed infant
T Harmon1, G Burkhart, H Applebaum
1Department of Surgery, Kaiser Foundation Hospital, Los Angeles, CA. 90027.
Journal of Pediatric Surgery
|June 1, 1992
Summary
A rare case of infant pseudomembranous colitis (PMC) occurred after the mother took antibiotics while breastfeeding. This highlights the risk of breast milk antibiotic transmission causing infant Clostridium difficile infection.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Medicine
- Infectious Diseases
Background:
- Pseudomembranous colitis (PMC) is a rare condition in infants, with surgical complications being even rarer.
- Previous cases of infant PMC involved direct antibiotic administration to the child.
Observation:
- A 2-month-old infant underwent bowel resection due to a perforated, thickened, and inflamed left colon.
- The infant's stool tested positive for Clostridium difficile toxin, consistent with PMC.
- The infant recovered after treatment with vancomycin.
Findings:
- The infant's mother reported self-administering ciprofloxacin while breastfeeding.
- Ciprofloxacin is known to concentrate in breast milk at levels exceeding maternal serum.
- Antibiotics transmitted via breast milk can lead to complicated PMC in infants.
Implications:
- A targeted patient history is crucial for diagnosing infant PMC.
- This case underscores the importance of considering maternal medication use in infant enterocolitis.
- Distinguishing PMC from other infantile enterocolitides is vital for appropriate management.