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Clostridium difficile peritonitis in a neonate. A case report.

V M Genta, P H Gilligan, L R McCarthy

    Archives of Pathology & Laboratory Medicine
    |January 1, 1984
    PubMed
    Summary

    A neonate experienced fatal peritonitis caused by Clostridium difficile. While symptoms suggested necrotizing enterocolitis, a mesenteric band was the underlying cause, with Clostridium difficile confirmed postmortem.

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    Area of Science:

    • Neonatal Medicine
    • Infectious Diseases
    • Surgical Pathology

    Background:

    • Neonatal necrotizing enterocolitis (NEC) is a serious gastrointestinal condition in premature infants.
    • Peritonitis in neonates can be life-threatening, often associated with gastrointestinal compromise.
    • Clostridium difficile is an opportunistic pathogen increasingly recognized in healthcare settings.

    Observation:

    • A neonate presented with clinical signs suggestive of NEC.
    • Laparotomy revealed a congenital mesenteric band as the primary cause of intestinal compromise.
    • Histopathology showed gram-positive rods within the small intestinal wall.

    Findings:

    • Clostridium difficile was identified as the causative agent of fatal peritonitis.
    • The organism was isolated from antemortem peritoneal fluid and postmortem blood cultures.
    • A mesenteric band was identified as the underlying pathology, distinct from typical NEC.

    Implications:

    • This case highlights the importance of considering Clostridium difficile in neonatal peritonitis, even with atypical presentations.
    • Congenital anomalies like mesenteric bands can predispose neonates to severe infections.
    • Accurate diagnosis and timely intervention are crucial for improving outcomes in neonatal surgical emergencies.

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