title: Clostridium difficile causing acute renal failure: case presentation and review.
abstract: OBJECTIVE
  Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population. Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.
  
  
  METHODS
  In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-year-old patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.
  
  
  RESULTS
  The link between Clostridium difficile-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.
  
  
  CONCLUSIONS
  Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.
authors.affiliation: Department of Emergency Medicine, Medical University Vienna, General Hospital, Wahringer Gurtel 18-20, A-1090, Austria.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Arrich
authors.forename: Gottfried-H
authors.initials: GH
authors.lastname: Sodeck
authors.forename: Gurkan
authors.initials: G
authors.lastname: Sengolge
authors.forename: Christoforos
authors.initials: C
authors.lastname: Konnaris
authors.forename: Marcus
authors.initials: M
authors.lastname: Mullner
authors.forename: Anton-N
authors.initials: AN
authors.lastname: Laggner
authors.forename: Hans
authors.initials: H
authors.lastname: Domanovits
mesh_terms: D058186:Acute Kidney Injury / Q000382:microbiology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole