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Rectal prolapse in a child: an unusual presentation of Clostridium difficile-associated pseudomembranous colitis

Shu-Ching Huang1, Yao-Jong Yang, Chung-Ta Lee

  • 1Department of Pediatrics, Kuo General Hospital, Tainan, Taiwan.

Pediatrics and Neonatology
|April 29, 2011
PubMed

Insights

Pseudomembranous colitis is rare in children but can occur after short antibiotic courses. This case highlights Clostridium difficile infection as a cause of rectal prolapse in a toddler, emphasizing prompt diagnosis and antibiotic withdrawal.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Pseudomembranous colitis is an uncommon complication of antibiotic use in pediatric patients.
  • Rectal prolapse is a rare presenting symptom of Clostridium difficile infection in children.

Observation:

  • A 14-month-old girl developed rectal prolapse following a 4-day course of cefuroxime for acute otitis media.
  • Diagnostic imaging revealed a pelvic mass and thickened rectal wall, while sigmoidoscopy showed characteristic pseudomembranes.

Findings:

  • Stool analysis confirmed Clostridium difficile infection with detection of toxins A and B.
  • Histopathology of colonic biopsy demonstrated superficial mucosal erosion and pseudomembrane adherence.

Implications:

  • Clostridium difficile infection should be considered in pediatric patients with rectal prolapse, particularly those with recent antibiotic exposure.
  • Discontinuation of antibiotics and supportive care are crucial for managing pediatric C. difficile-associated pseudomembranous colitis.

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