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Pseudomembranous colitis in a preterm neonate.

D B Singer, W J Cashore, J A Widness

    Journal of Pediatric Gastroenterology and Nutrition
    |March 1, 1986
    PubMed
    Summary
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    A preterm infant developed severe diarrhea and died from pseudomembranous colitis caused by toxin-producing Clostridioides difficile. This occurred 12 days after ampicillin treatment, highlighting antibiotic risks in neonates.

    Area of Science:

    • Neonatal Medicine
    • Infectious Diseases
    • Gastroenterology

    Background:

    • Antibiotic use in neonates can disrupt gut microbiota.
    • Clostridioides difficile infection (CDI) is a significant cause of healthcare-associated diarrhea.
    • Pseudomembranous colitis is a severe form of CDI.

    Observation:

    • A preterm infant presented with sudden onset diarrhea and abdominal distention.
    • The infant rapidly deteriorated and died within 60 hours.
    • Autopsy revealed fulminating pseudomembranous colitis and proctitis.

    Findings:

    • Toxin-producing Clostridioides difficile was isolated from stool samples.
    • Pseudomembranous colitis developed 12 days after the infant's last ampicillin dose.
    • Necrotizing enterocolitis, a distinct pathological condition, was also observed.

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    Implications:

    • This case underscores the potential for severe, fatal Clostridioides difficile infections in preterm infants following antibiotic exposure.
    • Early recognition and management of CDI are critical in neonatal intensive care units.
    • Further research into preventative strategies and safer antibiotic protocols for neonates is warranted.