Pol. Merkur. Lek (Pol. Med. J.), 2018, XLIV/264: 284-286 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2018, XLIV/264: 284-286

Title: Clostridium difficile infection in young people – 2 case reports 

Authors: Birczyńska M, Czepiel J, Pejka K, Biesiada G, Jędrychowski M, Sobczyk-Krupiarz I, Michalak M, Garlicki A. 

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Clostridium difficile infection in young people – 2 case reports

Birczyńska M1, Czepiel J1,2, Pejka K3, Biesiada G1,2, Jędrychowski M1,2, Sobczyk-Krupiarz I1,2, Michalak M3, Garlicki A1,2.

1Infectious Diseases Ward, University Hospital, Krakow, Poland; 2Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland; 3Students’ Scientific Society, Jagiellonian University Medical College, Krakow, Poland

Clostridium difficile infection (CDI) remains one of the most important healthcare-associated infections of the last two decades. The pathogen is a Gram-positive, toxin-producing, anaerobic, rod-shaped and sporeforming bacterium; it is ubiquitous in the human environment. Transmission occurs by the fecal-oral route. The consequence of the action of bacterial toxins is initially a local inflammatory reaction, which then goes into systemic inflammation. Clinical presentation is varied; some patients are asymptomatic, in symptomatic form the main symptom is diarrhea of varying severity, which is sometimes accompanied by acute abdominal pain, nausea, vomiting and high fever. Risk factors of CDI include prior antibiotic use, increasing age and recent hospitalisation. Extremely rarely does CDI occur in immunocompetent patients under 30 years of age, even if previously treated with an antibiotic. Here presented are two untypical cases of CDI development in the lower age group, in the presence of additional risk factors of comorbid gastrointestinal tract infections. Both developed infections are following recent infection – Salmonella enterididis in the first case and Salmonella typhi in the second case. Therefore, the article also contains basic principles for the diagnosis and treatment of Salmonella spp.

Key words: Clostridium difficile, risk factors, typhoid fever, age, Salmonella

Pol Med J, 2018; XLIV (264); 284–286