title: Fulminant, non-antibiotic associated Clostridium difficile colitis following Salmonella gastroenteritis.
abstract: In the last decade there has been increasing awareness of the virulence and changing epidemiology of Clostridium difficile (C. difficile). While the vast majority of clinical cases of C. difficile are associated with antimicrobial or nosocomial exposure, this syndrome has been well described in the absence of antibiotic use. We present an unusual case of fatal, non-antibiotic associated C. difficile colitis following Salmonella serotype Saintpaul gastroenteritis in a previously healthy young person. We review the typical risk factors for C. difficile colitis and fulminant disease. We also review the epidemiology of community-acquired C. difficile-associated disease (CA-CDAD) and highlight Salmonella infection as a potential risk factor for development of CA-CDAD.
authors.affiliation: Division of Hospital Medicine, Department of Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. halvorss@ohsu.edu
authors.forename: Stephanie A C
authors.initials: SA
authors.lastname: Halvorson
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Cedfeldt
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Hunter
mesh_terms: D016360:Clostridioides difficile / Q000472:pathogenicity; D004731:Endotoxins / Q000009:adverse effects*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000150:complications / Q000175:diagnosis; D006801:Humans; D012480:Salmonella Infections / Q000150:complications* / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D004731:Endotoxins; C027952:salmonella toxin