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Severe Clostridium difficile-associated disease in children

Marko Pokorn1, Anja Radsel, Milan Cizman

  • 1Departments of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia. marko.pokorn@mf.uni-lj.si

The Pediatric Infectious Disease Journal
|August 30, 2008
PubMed

Insights

Clostridium difficile-associated disease (CDAD) outbreaks in children are rare but serious, requiring intensive therapy and sometimes colectomy. Co-infections with enteric viruses and underlying conditions like Hirschsprung disease increase severity.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Microbiology

Background:

  • Clostridium difficile-associated disease (CDAD) is a significant cause of infectious diarrhea in children.
  • Outbreaks of CDAD in pediatric populations necessitate prompt identification and management strategies.

Observation:

  • Three pediatric cases of CDAD occurred within a short period, with two requiring intensive care.
  • One severe case of community-acquired CDAD was noted.
  • Two patients presented with underlying conditions (Hirschsprung disease, Down syndrome) and concurrent enteric viral infections (rotavirus, calicivirus).

Findings:

  • The cases highlight the potential for rapid CDAD progression in children, even in community settings.
  • Co-infection with enteric viruses may exacerbate CDAD severity.
  • Underlying comorbidities are associated with increased risk and complexity of CDAD management.

Implications:

  • These findings underscore the importance of vigilant surveillance for CDAD in pediatric settings.
  • Early diagnosis and aggressive treatment are crucial for improving outcomes in severe pediatric CDAD.
  • Further research into the synergistic effects of viral co-infections and underlying conditions on CDAD pathogenesis is warranted.

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