Clostridium difficile: A rare cause of pyogenic liver abscess.
Extra-intestinal infections due to Clostridium difficile have been reported rarely. Herein we report a case of pyogenic liver abscess from toxigenic C. difficile in an 80-year-old non-hospitalized woman with diabetes mellitus, cerebrovascular and cardiovascular diseases. The patient was admitted to the emergency department with fever and abdominal pain. There was no history of diarrhea or use of antibiotics. Laboratory parameters revealed signs of inflammation and elevated AST and ALT levels. Abdominal ultrasound and computer tomography showed multiple focal lesions in the bilateral liver lobes and hydropic gallbladder with stones. The patient underwent cholecystectomy and the liver abscesses were drained. Toxigenic C. difficile strains were isolated from the drained pus and also from the stool sample. According to repetitive-element PCR (rep-PCR) analyses both organisms were the same. The organisms were susceptible to antibiotics. Despite proper antibiotic therapy and surgical drainage, the patient succumbed to her illness.
Marmara University Medical School, Department of Microbiology, Istanbul, Turkey. Electronic address: nulger@marmara.edu.trs.
Nurver
N
Ulger Toprak
Marmara University Medical School, Department of Microbiology, Istanbul, Turkey.
Gulcin
G
Balkose
Marmara University Medical School, Department of General Surgery, Istanbul, Turkey.
Deniz
D
Durak
Marmara University Medical School, Department of General Surgery, Istanbul, Turkey.
Ender
E
Dulundu
Marmara University Medical School, Department of General Surgery, Istanbul, Turkey.
Tolga
T
Demirbaş
Marmara University Medical School, Department of General Surgery, Istanbul, Turkey.
Cumhur
C
Yegen
Marmara University Medical School, Department of Microbiology, Istanbul, Turkey.
Guner
G
Soyletir
D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002763:Cholecystectomy; D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D042882:Gallstones / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D046290:Liver Abscess, Pyogenic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
Anaerobe; Clostridium difficile; Pyogenic liver abscess