title: Clostridium difficile-associated disease in children with solid tumors.
abstract: OBJECTIVE
  The goal of this study was to describe the incidence of Clostridium difficile-associated disease (CDAD) in children with solid tumours.
  
  
  METHODS
  After documentation of a case of C. difficile-associated pseudomembranous colitis in a patient with neuroblastoma, the presence of C. difficile toxins A and B was prospectively tested in all children undergoing antineoplastic chemotherapy for solid tumours or lymphomas at the "G. Gaslini" Children Hospital in Genoa who presented abdominal pain.
  
  
  RESULTS
  From January 2005 to December 2006, nine (6%) out of 141 patients treated for solid tumours had C. difficile toxin A detected in their stools in the presence of abdominal symptoms including vomit, abdominal pain and diarrhoea. The majority of patients had a normal neutrophil count at onset of gastrointestinal disease No patient developed pseudomembranous colitis, and none died. All patients received antibiotics and/or antineoplastic drugs previously associated with CDAD.
  
  
  CONCLUSIONS
  CDAD may be a complication of children with solid tumours. Since this disease may be life threatening and cause epidemic clusters, this possibility must be kept in mind for the differential diagnosis of abdominal diseases in children with cancer, especially in absence of neutropenia.
authors.affiliation: Infectious Diseases Unit, G.Gaslini Children Hospital, Largo G.Gaslini, 5, 16147 Genoa, Italy. eliocastagnola@ospedale-gaslini.ge.it
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Teresa
authors.initials: T
authors.lastname: Battaglia
authors.forename: Roberto
authors.initials: R
authors.lastname: Bandettini
authors.forename: Ilaria
authors.initials: I
authors.lastname: Caviglia
authors.forename: Ivana
authors.initials: I
authors.lastname: Baldelli
authors.forename: Marilina
authors.initials: M
authors.lastname: Nantron
authors.forename: Cristina
authors.initials: C
authors.lastname: Moroni
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile; D003937:Diagnosis, Differential; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009447:Neuroblastoma / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies