title: Fulminant Clostridium difficile toxic megacolon in a pediatric heart transplant recipient.
abstract: CD can be a cause of diarrhea in pediatric heart transplant recipients. Fulminant colitis can develop in immunocompromised patients with CD and progress to toxic megacolon. We report a case of a 10-yr-old girl who developed CD diarrhea and subsequently fulminant colitis with clinical signs and symptoms of abdominal compartment syndrome. She was taken to the operating room emergently and found to have toxic megacolon. She underwent a sub-total abdominal colectomy and end-ileostomy, and made a rapid recovery. Rapid recognition of the severity of the disease in the post-operative transplant patient is imperative as abdominal compartment syndrome may develop requiring surgical management. In pediatric heart transplant patients with diarrhea, we recommend a heightened clinical awareness with aggressive treatment given the risk of progression to fulminant CD and toxic megacolon.
authors.affiliation: Division of Cardiology, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA.
authors.forename: Angira
authors.initials: A
authors.lastname: Patel
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Gossett
authors.forename: Tara
authors.initials: T
authors.lastname: Benton
authors.forename: Erin
authors.initials: E
authors.lastname: Rowell
authors.forename: Hyde
authors.initials: H
authors.lastname: Russell
authors.forename: Elaine
authors.initials: E
authors.lastname: Cham
authors.forename: Elfriede
authors.initials: E
authors.lastname: Pahl
mesh_terms: D002648:Child; D016360:Clostridioides difficile / Q000378:metabolism*; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000601:surgery* / Q000628:therapy; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007081:Ileostomy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D059325:Intra-Abdominal Hypertension / Q000628:therapy; D008532:Megacolon, Toxic / Q000150:complications / Q000601:surgery*; D012306:Risk
chemical_list: D007166:Immunosuppressive Agents