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Relapsing pseudomembranous colitis
Abstract:
Pseudomembranous colitis secondary to C. difficile and its toxin(s) is a well-recognized disease in children and usually responds to treatment with oral vancomycin. There are well-documented reports of relapse in adults after initial successful treatment with vancomycin. This report documents relapse in a child who developed diarrhea following treatment of pseudomembranous colitis. Stool cultures were negative for C. difficile at the end of the initial course of treatment, but the organism was isolated from the stool when the diarrhea recurred. The symptoms improved following a second course of treatment with vancomycin and have not recurred during 8 months of follow-up monitoring.
Insights
Recurrent Clostridioides difficile infection (CDI) can occur in children treated with vancomycin for pseudomembranous colitis. This case highlights a child experiencing CDI relapse after initial treatment, emphasizing the need for vigilance.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Pseudomembranous colitis caused by Clostridioides difficile (C. diff) is common in children, typically treated with oral vancomycin.
- Relapse of C. diff infection is documented in adults but less frequently reported in pediatric cases.
- Initial vancomycin treatment often leads to symptom resolution.
Observation:
- A child diagnosed with pseudomembranous colitis experienced recurrent diarrhea after completing oral vancomycin therapy.
- Stool cultures initially negative for C. diff became positive upon recurrence of symptoms.
- The patient's symptoms resolved after a second course of vancomycin.
Findings:
- This case documents the recurrence of C. diff infection in a pediatric patient following standard vancomycin treatment.
- Negative stool cultures post-treatment do not entirely rule out the possibility of relapse.
- Successful re-treatment with vancomycin indicates its efficacy in managing recurrent CDI in children.
Implications:
- Pediatricians should consider the possibility of C. diff relapse even after negative initial stool cultures.
- Further research into the long-term management and prevention of recurrent CDI in children is warranted.
- This case contributes to the understanding of C. diff infection dynamics in pediatric populations.