Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

Clostridium difficile Colitis Associated with Infant Botulism: Near-Fatal Case Analogous to Hirschsprung's Enterocolitis

Robert Schechter, Bradley Peterson, James McGee, Olajire Idowu and John Bradley
Clinical Infectious Diseases
Vol. 29, No. 2 (Aug., 1999), pp. 367-374
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4460891
Page Count: 8
  • Download ($42.00)
  • Subscribe ($19.50)
  • Cite this Item
Clostridium difficile Colitis Associated with Infant Botulism: Near-Fatal Case Analogous to Hirschsprung's Enterocolitis
Preview not available

Abstract

We present the first five reported cases of Clostridium difficile-associated diarrhea (CDAD) in children with infant botulism caused by Clostridium botulinum. We compare two fulminant cases of colitis in children with colonic stasis, the first caused by infant botulism and the second caused by Hirschsprung's disease. In both children, colitis was accompanied by hypovolemia, hypotension, profuse ascites, pulmonary effusion, restrictive pulmonary disease, and femoral-caval thrombosis. Laboratory findings included pronounced leukocytosis, hypoalbuminemia, hyponatremia, coagulopathy, and, when examined in the child with infant botulism, detection of C. difficile toxin in ascites. CDAD recurred in both children, even though difficile cytotoxin was undetectable in stool after prolonged initial therapy. Four children who had both infant botulism and milder CDAD also are described. Colonic stasis, whether acquired, as in infant botulism, or congenital, as in Hirschsprung's disease, may contribute to the susceptibility to and the severity of CDAD.

Page Thumbnails

  • Thumbnail: Page 
367
    367
  • Thumbnail: Page 
368
    368
  • Thumbnail: Page 
369
    369
  • Thumbnail: Page 
370
    370
  • Thumbnail: Page 
371
    371
  • Thumbnail: Page 
372
    372
  • Thumbnail: Page 
373
    373
  • Thumbnail: Page 
374
    374