Pseudomembraneous clostridium after autologous bone marrow transplantation.
Clostridium difficile (C. difficile) pseudomembraneous colitis was diagnosed in a 13-year-old boy with Hodgkin's disease 3 months after autologous bone marrow transplantation. Hematopoiesis was fully reconstituted at the time. C. difficile infection occurred after gall bladder empyema had been treated conservatively with i.v. antibiotics and prophylactic 4-week administration of oral amoxicillin. C. difficile colitis was diagnosed early and intensive supportive therapy combined with administration of i.v. and subsequently oral vancomycin therapy failed. It is a phenomenon rarely seen and successful eradication of the clostridium infection was only achieved by a combination of higher dose vancomycin with metronidazole. During the post-colitis recovery the patient experienced a relapse of Hodgkin's disease and died following further surgical intervention 137 days post-transplantation.
Kavan
P
P
Department of Pediatric Oncology, 2nd Faculty of Medicine, Charles University Hospital Motol, Prague, Czech Republic.
Sochor
M
M
Nyc
O
O
Lochmann
O
O
Koutecky
J
J
Skala
P J
PJ
McClain
L K
LK
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000994:Antitrichomonal Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000209:etiology*; D006410:Hematopoiesis; D006689:Hodgkin Disease / Q000150:complications / Q000628:therapy; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D014182:Transplantation, Autologous; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000994:Antitrichomonal Agents; D008795:Metronidazole; D014640:Vancomycin