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Clostridium difficile in haematological malignancy.

A Rampling, R E Warren, P C Bevan

    Journal of Clinical Pathology
    |April 1, 1985
    PubMed
    Summary
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    Clostridium difficile infection in cancer patients can cause severe, atypical illness with jaundice and abdominal issues, sometimes leading to rapid death. Early recognition of this syndrome is crucial for patient outcomes.

    Area of Science:

    • Infectious Diseases
    • Hematology
    • Gastroenterology

    Background:

    • Clostridium difficile is a common cause of antibiotic-associated diarrhea.
    • Patients with hematological malignancies are at increased risk for C. difficile infections.
    • Toxigenic C. difficile strains can cause severe gastrointestinal illness.

    Purpose of the Study:

    • To describe a severe, atypical syndrome associated with Clostridium difficile in patients with hematological malignancies.
    • To identify clinical features and outcomes of this unusual C. difficile presentation.
    • To discuss the clinical implications of recognizing this syndrome.

    Main Methods:

    • Retrospective review of 20 patients with hematological malignancies and C. difficile infection or colonization.

    Related Experiment Videos

  • Analysis of clinical features, including jaundice, abdominal symptoms, and bowel habits.
  • Detection of fecal cytotoxin (toxin B) and blood cultures for C. difficile.

    • Main Results:

    • All C. difficile isolates were toxigenic in vitro.
    • Fecal cytotoxin was detected in 20/26 episodes.
    • Ten episodes presented with a severe, atypical illness characterized by jaundice, abdominal distension, and altered bowel function, with four deaths within seven days.
    • Bacteraemia was common in neutropenic patients and C. difficile was isolated from blood cultures in two cases.

    Conclusions:

    • A severe, atypical Clostridium difficile-associated syndrome can occur in patients with hematological malignancies.
    • This syndrome presents with distinct features including pronounced jaundice and abdominal symptoms.
    • Recognition of this atypical syndrome is critical for timely management and improved patient outcomes.