Fulminant Clostridium difficile colitis in a patient with spinal cord injury: case report.
BACKGROUND
In certain patients with Clostridium difficile colitis (CDC), a life-threatening systemic toxicity may develop despite appropriate and timely medical therapy.


METHODS
Literature search and case report.


RESULTS
A 39-year-old man with T10 paraplegia presented with a distended, quiet abdomen following recent treatment with antibiotics for pneumonia. Diarrhea was not present. Complete blood counts demonstrated a marked leukocytosis. A CT scan of the abdomen demonstrated a state of diffuse pancolonic inflammation with peritoneal fluid. The patient was taken to the operating room and underwent total abdominal colectomy with oversewing of the rectal stump and end ileostomy for treatment of the fulminant CDC.


CONCLUSIONS
Patients with spinal cord injury (SCI) often receive antibiotics for infections of the aerodigestive tree and urinary tract and for problems with skin integrity. A heightened awareness of the development of fulminant CDC remains essential in the care of patients with SCI. Any unexplained abdominal illness after recent antibiotic administration should alert the physician to CDC and its potential as a fulminant, potentially fatal illness.
Department of Surgery, St. Louis University School of Medicine, St. Louis, Missouri, USA.
Anil N
AN
Bahadursingh
Parsia A
PA
Vagefi
Walter E
WE
Longo
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016360:Clostridioides difficile; D003082:Colectomy; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy; D013119:Spinal Cord Injuries / Q000150:complications*
D000900:Anti-Bacterial Agents