Journal
SURGICAL CASE REPORTS
Volume 7, Issue 1, Pages -Publisher
SPRINGER
DOI: 10.1186/s40792-021-01220-9
Keywords
Clostridioides (Clostridium) difficile infection; Fulminant colitis; Proctocolectomy; PCR-ribotype 027; Helicobacter pylori eradication therapy; Community-acquired CDI
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This case report presents a rare case of community-acquired fulminant pseudomembranous colitis caused by ribotype 027 C. difficile after H. pylori eradication therapy in a 68-year-old woman. In Japan, this strain is reported to be uncommon, making this case notable.
Background Clostridioides (Clostridium) difficile infection (CDI) has become an increasingly significant disease not only as healthcare-associated infection, but also as community-acquired (CA) infection worldwide. CDI caused by the NAP1/BI/027 strain is reported to be more severe, difficult to cure, and frequently associated with recurrences in North America and Europe. Case presentation A 68-year-old woman was referred to our hospital for continuous lower abdominal pain 4 weeks after eradication therapy against Helicobacter pylori. While she was treated with fasting on the suspicion of ischemic colitis, she experienced septic shock. Emergent subtotal proctocolectomy revealed fulminant pseudomembranous C. difficile colitis. The C. difficile isolate recovered from the patient was identified as ribotype 027, which has been reported to be uncommon in Japan. Conclusion We report a rare case of CA fulminant pseudomembranous colitis caused by ribotype 027 C. difficile after H. pylori eradication therapy.
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