title: Diarrhea in elderly patients due to Clostridium difficile associated with Salmonella and Shigella infection.
abstract: Clostridium difficile is the main cause of nosocomial diarrhea mainly in elderly hospitalized patients and in nursing homes, but less common in the community. We report three elderly patients living in the community, one frail and two in reasonable good health who recently developed diarrhea due to C. difficile associated with Salmonella group C in two cases and Shigella flexneri in the other. The association with Shigella has not previously been reported and there have only been a few cases with Salmonella. These findings may be important due to the possibility that diarrhea caused by C. difficile associated with other enteric bacteria may be more prevalent than expected in the aging population, thus necessitating awareness and consequently appropriate treatment and follow-up.
authors.affiliation: Department of Geriatrics, Rabin Medical Center, Beilinson Campus, Sackler School of Medicine, Tel Aviv University, Petach Tikvah 49100, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Grinblat
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.forename: Boris
authors.initials: B
authors.lastname: Grosman
authors.forename: Dror
authors.initials: D
authors.lastname: Dicker
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000472:pathogenicity*; D017714:Community-Acquired Infections / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology*; D004405:Dysentery, Bacillary / Q000150:complications*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D005260:Female; D006801:Humans; D012480:Salmonella Infections / Q000150:complications*; D012763:Shigella flexneri / Q000472:pathogenicity*