title: A case of multiple recurrence of Clostridium difficile infection with severe hematochezia in an immunocompromised host.
abstract: Clostridium difficile infection (CDI) is increasing in incidence and severity. Clinically, diarrhea frequently occurs, but severe hematochezia is rarely seen with CDI. We describe here a hematopoietic stem cell transplantation (HSCT) recipient who experienced life-threatening gastrointestinal bleeding due to severe CDI. Subsequent stool surveillance and molecular typing observed the patient who had two episodes of recurrence with a new strain of C. difficile distinct from the initial infection. We analyze C. difficile strains obtained from the patient, and also discuss the diagnosis and treatment of this case.
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Xuewu
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Yunbo
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Silan
authors.initials: S
authors.lastname: Gu
authors.affiliation: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Beiwen
authors.initials: B
authors.lastname: Zheng
authors.affiliation: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lv
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors.forename: Yinjun
authors.initials: Y
authors.lastname: Lou
authors.affiliation: Department of Hematology, Institute of Hematology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China. Electronic address: zjuhematology@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
mesh_terms: D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D003967:Diarrhea / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000473:pathology / Q000628:therapy; D012008:Recurrence; D055815:Young Adult
keywords: Clostridium difficile infection; Multilocus sequence typing (MLST); Treatment