Related Experiment Videos
[Bacteremia due to Clostridium difficile]
Isao Nakamur1, Masako Kunihiro, Haru Kato
1Personnel Clinic, Yamaguchi Prefectural Government.
Summary
Clostridium difficile bacteremia in a burn patient was successfully treated with vancomycin. This case highlights effective management of antibiotic-associated colitis and bacteremia in complex surgical patients.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Burn Care
Background:
- A 69-year-old female burn patient received prophylactic antibiotics (cefazolin and flomoxef) prior to debridement and skin grafting.
- Postoperatively, the patient developed severe symptoms including high fever, abdominal pain, and watery diarrhea, suggestive of antibiotic-associated colitis.
Observation:
- Blood cultures revealed bacteremia with Clostridium difficile (C. difficile), Enterococcus faecalis, and Enterococcus casseliflavus.
- Stool analysis confirmed C. difficile infection (CDI) with positive toxin A & B detection and identical PCR ribotyping across isolates.
Findings:
- Intravenous and oral vancomycin therapy was initiated, leading to initial improvement.
- Despite treatment, the patient experienced recurrent diarrhea and CDI, necessitating a prolonged course of oral vancomycin.
- The patient ultimately recovered and was discharged after a comprehensive treatment regimen.
Implications:
- This case underscores the successful use of vancomycin in treating C. difficile bacteremia, even in immunocompromised burn patients.
- It highlights the challenges of managing recurrent CDI in patients with complex medical histories and prolonged antibiotic exposure.
- Effective management strategies for CDI in surgical and critically ill patients require careful consideration of antibiotic stewardship and treatment duration.