C. difficile-associated enterocolitis in a child: a clinical case

Antibiotic-associated diarrhea (AAD) is one of the most significant complications of antibacterial treatment. The objective of the study was to provide a clinical case of C. difficile-associated enterocolitis in a child. Case description. A clinical case of moderate enterocolitis caused by C. difficile is presented in a 4-year-old child who fell ill while taking 3 courses of antibiotics (cefotaxime, claptrithromycin, amikacin), which manifested as abdominal pain, false attempts to defecate, frequent scanty mucous stool with blood admixture, fever. At the same time, negative results were obtained from bacteriological stool culture for enteropathogenic microflora and stool testing for intestinal viruses using ELISA and PCR; a questionable result was obtained at stool testing for the type A and B C. difficile toxins. A general blood test showed neutrophilic leukocytosis and a left shift in the differential leukocyte counts, inflammatory changes in the coprogram, thickening of the colon wall up to 3-4.5 mm according to ultrasound data, enlarged mesenteric lymph nodes were found. Upon anti-infectious therapy with vancomycin and metronidazole, rapid positive dynamics of the child’s condition and recovery were noted. Conclusions. The diagnosis of C. difficile-associated infection should be established on the basis of a comprehensive analysis of available clinical, epidemiological, anamnestic, laboratory and instrumental data. Negative or questionable results of the test for C. difficile toxins A and B in feces does not exclude an infection associated with C. difficile.