Extraintestinal Clostridium difficile Infections

Mattila, Eero; Arkkila, Perttu; Mattila, Petri S.; Tarkka, Eveliina; Tissari, Päivi; Anttila, Veli-Jukka

doi:10.1093/cid/cit392

Cited by 67 publications

(76 citation statements)

References 40 publications

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“…2 Extraintestinal infection has been described in visceral organs, skin and soft tissues, joints, and, in cases of empyema, brain empyema in association with chronic subdural hematoma, and bacteremia. [3][4][5][6][7] Clostridium difficile pericarditis has been described once before 8 in the presence of acute colitis with presumed bacteremia, but indolent infection of an epicardial patch occurring months after documented C. difficile bacteremia has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Getting to a Man's Heart through His Colon

Samsky¹,

DeVore²,

Durkin³

et al. 2016

Texas Heart Institute Journal

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E valuating the efficacy of the Dor procedure when that procedure is added to coronary artery bypass surgery was one of the 2 major objectives of the Surgical Treatment for Ischemic Heart Failure (STICH) trial, the results of which were reported in 2009.1 The Dor procedure involves removing both akinetic and dyskinetic segments of the anterior wall and reshaping the left ventricle (LV), in order to restore its original elliptical form. Here, we describe the case of a patient who, 10 years after receiving a Dacron epicardial patch as a research subject in the STICH trial, presented with purulent pericarditis from Clostridium difficile. Case ReportIn March 2013, a 69-year-old man presented with a progressively enlarging pulsatile mass in the left side of his chest. He had no constitutional symptoms and reported no symptoms of decompensated heart failure, such as shortness of breath, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, or peripheral edema. Nor did he have abdominal symptoms suggestive of volume overload. Physical examination revealed a temperature of 37.3 °C, a heart rate of 70 beats/min, a blood pressure of 122/58 mmHg, and a large, pulsating mass protruding from his chest wall, surrounded by erythema. His medical comorbidities included ischemic cardiomyopathy with an LV ejection fraction recently measured at 0.15, chronic obstructive pulmonary disease with emphysema, chronic kidney disease, alcohol abuse, and tubulovillous adenoma of the transverse colon. His surgical history included (in 2003) coronary artery bypass grafting combined with the Dor procedure (including placement of a felt-and-Dacron epicardial patch), as well as a transverse colectomy (in 2012).Six months before this presentation, he had been admitted to another hospital for non-ST-segment-elevation myocardial infarction and cardiogenic shock, an admission that was complicated by C. difficile bacteremia without colitis. Two weeks of treatment with metronidazole achieved clearance of blood cultures and clinical resolution. No obvious cause for the C. difficile bacteremia was found; the evaluation included a negative computed tomographic (CT) scan of the abdomen and pelvis.

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Section: Discussionmentioning

confidence: 99%

Getting to a Man's Heart through His Colon

Samsky¹,

DeVore²,

Durkin³

et al. 2016

Texas Heart Institute Journal

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“…La sua azione patogena si esplica nel 99% dei casi nella colite [1], che configura la Clostridium difficile Infection (CDI) [2][3][4]. Questa condizione rappresenta una vera e propria sindrome in costante e importante incremento in tutto il mondo occidentale [5][6][7][8][9].…”

Section: Introduzioneunclassified

Fidaxomicin in the treatment of colitis due to Clostridium difficile: preliminary results

Cortese

Meledandri

Ballardini

et al. 2014

CMI

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5y sostenute, anche nello stesso ambito ospedaliero, da ceppi batterici differenti anche con diversa virulenza [21][22][23][24][25]; y complicanze di percorsi clinici intensivi, chirurgici, internistici spesso combinati tra loro [26][27][28][29][30][31][32]; y caratterizzate dalla necessità di intraprendere misure ospedaliere logistiche articolate come l'isolamento dei pazienti [33,34]; y causa di incremento dei costi di ricovero [35,36]. La CDI non è quasi mai un'infezione de novo, ma colpisce soggetti con patologie attive o nel decorso di procedure diagnosticooperative spesso articolate. Sono stati indi- INTRODUZIONEClostridium difficile è un bacillo Gram-positivo, anaerobio e sporigeno. La sua azione patogena si esplica nel 99% dei casi nella colite [1], che configura la Clostridium difficile Infection (CDI) [2][3][4]. Questa condizione rappresenta una vera e propria sindrome in costante e importante incremento in tutto il mondo occidentale [5][6][7][8][9]. Le CDI sono: y nella stragrande maggioranza dei casi infezioni nosocomiali di pazienti complessi nei quali aumentano morbilità e mortalità [10][11][12][13][14][15]; y causa di sindromi differenti con coefficienti di gravità diversi [16][17][18][19][20];

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“…Because C. difficile is a fastidious anaerobe and is often isolated with other microbes, its isolation often is difficult and challenging and emphasizes the need for sensitive microbiologic detection methods (8,9). In distinction from intestinal infections, where the diagnostic criteria are well defined, the significance of isolation of C. difficile from extraintestinal sites can sometimes be unclear.…”

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confidence: 99%