Multiple episodes of paediatric Clostridioides difficile infection (pCDI) in the context of autoimmune polyendocrine...

Area of Science:

• Pediatric Infectious Diseases
• Immunology
• Genetics

Background:

• Recurrent Clostridioides difficile infection (CDI) poses significant challenges in pediatric care.
• Autoimmune polyendocrine syndrome type 1 (APS-1) is a rare genetic disorder leading to immune dysregulation and increased infection susceptibility.

Purpose of the Study:

• To report the first pediatric case of CDI associated with APS-1.
• To describe the clinical course and management of recurrent CDI in an immunocompromised child with APS-1.

Main Methods:

• Case report detailing a pediatric patient with multiple CDI episodes.
• Review of treatment strategies including metronidazole, vancomycin, and fidaxomicin.
• Diagnostic workup for underlying immune deficiencies, leading to APS-1 diagnosis.

Main Results:

• The patient experienced severe, recurrent CDI episodes.
• Fidaxomicin administration led to sustained clinical remission of CDI symptoms.
• The patient was subsequently diagnosed with APS-1, explaining the immunocompromised state.

Conclusions:

• This is the first reported case linking pediatric CDI to APS-1.
• Underlying immune deficiency in APS-1 may predispose children to recurrent CDI.
• Fidaxomicin shows efficacy in managing recurrent CDI in immunocompromised pediatric patients.