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Clostridium difficile infection in a patient with Crohn disease

Chien-Hui Hsu1, Yung-Ming Jeng, Yen-Hsuan Ni

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|July 4, 2012
PubMed

Insights

A rare pediatric Crohn disease case presented with Clostridium difficile infection mimicking a flare-up. Eradicating C. difficile resolved symptoms, highlighting the importance of considering infections in Crohn disease exacerbations.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Inflammatory Bowel Disease

Background:

  • Crohn disease is a chronic inflammatory disorder rarely seen in children.
  • The exact causes of Crohn disease exacerbations are not fully understood.
  • Clostridium difficile infection is a known cause of gastrointestinal distress.

Observation:

  • A 14-year-old girl with Crohn disease experienced acute gastrointestinal symptoms.
  • Her symptoms mimicked a Crohn disease flare-up but were caused by toxin A-producing Clostridium difficile.
  • She had not recently used antibiotics, an unusual factor for C. difficile.

Findings:

  • Standard steroid treatment for Crohn disease was ineffective.
  • Complete symptom resolution and a three-year remission followed C. difficile eradication.
  • This suggests C. difficile can present atypically in pediatric Crohn disease.

Implications:

  • Clinicians should consider C. difficile infection in pediatric Crohn disease patients presenting with acute gastrointestinal symptoms, even without prior antibiotic use.
  • Prompt diagnosis and targeted treatment of C. difficile can lead to significant symptom improvement and prolonged remission in Crohn disease.
  • This case highlights the diagnostic challenge and therapeutic implications of co-existing infections in inflammatory bowel disease.

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