Table 1 Cases of Clostridioides difficile infection in children
From: Clostridioides difficile infection in infants: a case report and literature review
Author | Year | Age | Sex | Exposure | Symptoms | Laboratory results | Other pathogens | Comorbidities | Detection of C. difficile | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
Cappella M et al.[30] | 2016 | 6-year | Male | Amoxicillin-clavulanate | Watery diarrhea, abdominal pains, fever, reactive Arthritis | CRP, mg/L: 39 Erythrocyte sedimentation rate, mm/h: 30 | Salmonella (-); Shigella (-); Yersinia (-); Campylobacter (-); Viruses (-) | No | ELISA (Toxins) | Oral naproxen and metronidazole | Cured |
Durand CL et al.[31] | 2009 | 10-year | Female | Erythromycin; Penicillin | Hip pain, diarrhea, fever, reactive Arthritis | CRP, mg/dL: 12 WBC, 109/L: 15.4 | Bacteria (-); Viruses (-); Ova (-); Cysts (-); Parasites (-) | No | ELISA (Toxins) | Oral and intravenous metronidazole | Cured |
Liang Y et al.[32] | 2020 | 6-year | Female | Chemotherapy; Cephalosporin; Vancomycin; Imipenem; Carprofen | Fever, diarrhea with jelly-like stools, abdominal distension, nausea, vomiting, shortness of breath, massive hydrothorax and ascites | CRP, mg/L: 220 WBC, 109/L: 15.4 Hemoglobin, g/dL: 6.9 Albumin, g/dL: 2.8 Dehydrogenase, U/L: 282 | Common bacteria and fungiculture (-); Rotavirus (-); Adenoviridae antigens (-) | Lymphoma | RT-PCR (Toxin gene) | Oral vancomycin and Saccharomyces boulardii | Cured |
Rojas GM et al.[33] | 2018 | 5-month | Female | No | Watery diarrhea, abdominal distension | WBC, 103/µL: 9.5 CRP, mg/dL: 18 Erythrocyte sedimentation rate, mm/h: 64 | Salmonella (-); Shigella (-); E. coli O157:H7 (-); Vibrio (-); Yersinia (-); Campylobacter (-) | Kawasaki disease | PCR (Toxin gene) | Oral metronidazole | NA |
Rojas GM et al.[33] | 2018 | 4-year | Male | Penicillin | Non-bilious, non-bloody vomiting and abdominal distension | WBC, 103/µL: 9.2 CRP, mg/dL: 17.6 Erythrocyte sedimentation rate, mm/h: 110 | Salmonella (-); Shigella (-); E. coli O157:H7 (-); Vibrio (-); Yersinia (-); Campylobacter (-) | Kawasaki disease | PCR (Toxin gene) | Oral metronidazole | NA |
Price EH et al.[34] | 1988 | 2-month | Female | No | Non-bloody diarrhea, vomiting, fever, acute enterocolitis | WBC, 109/L: 4.4 PLT, 109/L: 305–616 | Campylobacter (-); enteropathogenic Escherichia coli (-); Salmonella (-); Shigella (-); Viruses (-); E coli 013 (a non-enteropathogenic serotype) (+); Yersinia enterocolitica (-); Pseudotuberculosis (-) | No | TC | Intravenous metronidazole | Cured |
Price EH et al.[34] | 1988 | 3-week | Female | Anticholinergic drug (pipenzolate bromide) | Profuse watery, but non-bloody diarrhea, acute enterocolitis | WBC, 109/L: 20.5 PLT, 109/L: 25,000 | enteropathogenic E coli (-); Salmonella (-); Shigella (-); Campylobacter (-); Viruses (-); Yersinia enterocolitica (-) | No | TC | Intravenous benzylpenicillin, gentamicin and metronidazole | Cured |
Loffler HA et al.[35] | 2004 | 6-year | Female | NA | Fever, nausea, vomit, watery diarrhea, reactive arthritis | WBC, 109/L: 16.9 CRP, mg/L: 21 Erythrocyte sedimentation rate: 61Â mm/h Fibrinogen, g/L: 9 | Yersinia enterocolitica (-); Shigella (-); Salmonella (-); Campylobacter (-) | No | EIA (Toxins) | Diclofenac and vancomycin | Cured |
Nogueira H et al.[36] | 2021 | 2.5-year | Female | Immunosuppressive medication (Prednisone/Tacrolimus/Mycophenolate sodium) | Bloody and mucoid stool | WBC, /mm3: 10,420 Hemoglobin, g/dL: 10.5 | Intestinal parasites (i.e. protozoa and helminths) (-); Gastrointestinal viruses (-); Enteric pathogens (-) | Liver transplantation | TC; EIA (Toxins) | Metronidazole | Cured |
Quesada-Gomez C et al.[37] | 2012 | 18-month | Female | Azithromycin; Diclofenac | Watery diarrhea with mucous | Normal | Protozoa (-); Helminthes (-); Gastrointestinal viruses (-); Bacterial enteric pathogens (-) | No | TC, EIA (Toxins) | Metronidazole and probiotic (commercial Saccharomyces and Bacillus spores) | Cured |
Yang Hongbin et al.[38] | 2018 | 2-year | Female | Cephalosporin | Diarrhea | WBC, 109/L: 14.63 PLT, 109/L: 539 | Mycobacterium tuberculosis (-); Cytomegalovirus (-); Herpes simplex virus (-) | No | Colonoscopy; EIA (GDH/Toxins) | Oral metronidazole and probiotics (Bacillus subtilis) | Cured |
Guan Jun et al.[39] | 2017 | 6-year | Female | Cefadroxil; Cephalosporins; Cefixime | Diarrhea, abdominal pain | ALT:9.0 IU/L AST: 30I U/L Alpha hydroxybutyrate dehydrogenase, IU/L: 455 Lactic dehydrogenase, IU/L: 509 | Shigella (-); Salmonella (-); Pathogenic Escherichia coli (-); Vibrio cholerae (-); Campylobacter jejuni (-); Rotavirus (-); Enterovirus (-); Cytomegalovirus (-); EB virus (-) | No | Colonoscopy; EIA (GDH/Toxins) | Oral metronidazole and probiotics (Saccharomyces boulardii) | Cured |
Kader A et al.[40] | 2004 | 7-week | Male | No | Loose stools and faltering weight | WBC, 109/L: 21.05 CRP, mg/L: 45 | Bacteria (-); Viruses (-); Ova (-); Cysts (-) | No | ELISA (Toxins) | Oral metronidazole | Cured |
Our patient | 2021 | 1-month | Female | Piperacillin, tazobactam, cefoperazone, sulbactam, fluconazole, vancomycin meropenem and azithromycin | Diarrhea, loose yellow stools | WBC, 109/L: 26.30 PLT, 109/L: 599 HsCRP, mg/L: 157.2 | Protozoa and helminths (-); Rotavirus (-); Shigella (-); Salmonella (-); Pathogenic Escherichia coli (-); Plesiomonas and Aeromonas (-) | No | TC, NAAT, Combined GDH and toxin EIA | Intravenous norvancomycin and oral norvancomycin, probiotics | Cured |