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[A rare cause of severe diarrhea in children: pseudomembranous colitis]
C Radet1, J L Ginies, F Coirier
1Service de pédiatrie B, centre Robert-Debré, CHU, Angers, France.
Background:
Pseudomembranous colitis is a rare and serious complication of treatment by antibiotics. The case of a patient with a protracted pseudomembranous colitis followed by two relapses is reported.
Case Report:
A 4 year-old boy was admitted after 18 days of profuse and feverish diarrhea. He had been given amoxycillin for 10 days, one and a half months previously. His temperature was 40 degrees C; he had abdominal pain and leucocytosis was 30,000/mm3. The situation rapidly improved with digestive rest and i.v. antibiotic therapy. Relapse of diarrhea together with bilious vomiting and acute abdominal pains required readmission three days after his discharge. Search for Clostridium difficile in stools remained negative. The diagnosis of pseudomembranous colitis was confirmed by sigmoidoscopy and intestinal biopsy. The patient was given parenteral nutrition for 3 weeks and vancomycin. The disease was complicated by anasarca related to severe protein-loosing enteropathy but evolution was finally favourable after a two month period.
Conclusion:
Pseudomembranous colitis remains a serious affection in childhood; its prognosis largely depends on the precocity of diagnosis and treatment.
Insights
Pseudomembranous colitis, a severe complication of antibiotic treatment, can occur in children. Early diagnosis and prompt treatment are crucial for favorable outcomes in pediatric cases.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
Background:
- Pseudomembranous colitis is a rare but serious complication following antibiotic therapy.
- Antibiotic-associated diarrhea necessitates careful consideration of potential complications.
Observation:
- A 4-year-old boy presented with prolonged, severe diarrhea after amoxicillin treatment.
- Initial symptoms included high fever, abdominal pain, and leukocytosis, improving with supportive care.
- Recurrence of severe gastrointestinal symptoms led to readmission, with negative stool tests for Clostridium difficile.
Findings:
- Diagnosis of pseudomembranous colitis was confirmed via sigmoidoscopy and intestinal biopsy.
- The patient developed anasarca due to protein-losing enteropathy.
- Treatment involved parenteral nutrition and vancomycin, leading to a favorable outcome after two months.
Implications:
- Pseudomembranous colitis is a significant concern in pediatric patients.
- Prompt diagnosis and timely intervention are critical for improving prognosis in childhood pseudomembranous colitis.
- This case highlights the importance of considering pseudomembranous colitis even with negative initial stool tests.