<i>Сlostridium difficile</i> Infection in a COVID-19 Patient
Aim. The clinical observation highlights plausible compound origins of diarrhoea, fever and neutrophilic leucocytosis in COVID-19 and the rationale to exclude Clostridium difficile infection in such patients.Key points. A 57-yo female patient was admitted in May 2020 with the complaints of 39 °C fev...
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| Format: | Article |
| Language: | Russian |
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Gastro LLC
2021-10-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/551 |
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| author | A. A. Timofeeva Yu. O. Shulpekova V. M. Nechaev M. R. Skhirtladze |
| author_facet | A. A. Timofeeva Yu. O. Shulpekova V. M. Nechaev M. R. Skhirtladze |
| author_sort | A. A. Timofeeva |
| collection | DOAJ |
| description | Aim. The clinical observation highlights plausible compound origins of diarrhoea, fever and neutrophilic leucocytosis in COVID-19 and the rationale to exclude Clostridium difficile infection in such patients.Key points. A 57-yo female patient was admitted in May 2020 with the complaints of 39 °C fever, general weakness, polymyalgia, diarrhoea to 3–4 times a day (mushy stool, no morbid inclusions). Initial diarrhoea was non-severe and likely triggered by the coronavirus infection. A background antibiotic and putative-immunosuppressive therapy proceeded with watery diarrhoea to 7–8 times a day and C. difficile toxins A and B detected in stool. The C. difficile infection relapsed on day 10 of vancomycin withdrawal and associated with elevated body temperature, diarrhoea and neutrophil leucocytosis; signs of colitis determined in ultrasound and CT. Exacerbation was successfully treated in a repeated metronidazole-combined vancomycin course.Conclusion. Patients with COVID-19 are at risk of clostridial colitis due to massive antibiotic, systemic glucocorticoid and biologics-based therapy they receive. The opportunistic bacterial infection of C. difficile often proceeds undetected due to its potential mirroring of COVID-19 presentation. A screening algorithm in COVID-19 patients with diarrhoea should imply steps for C. difficile detection. |
| format | Article |
| id | doaj-art-02053d5e8fa943ffa9316cae364f7122 |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2021-10-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-02053d5e8fa943ffa9316cae364f71222025-02-10T16:14:36ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732021-10-01313687310.22416/1382-4376-2021-31-3-68-73427<i>Сlostridium difficile</i> Infection in a COVID-19 PatientA. A. Timofeeva0Yu. O. Shulpekova1V. M. Nechaev2M. R. Skhirtladze3Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Sechenov First Moscow State Medical University (Sechenov University)Aim. The clinical observation highlights plausible compound origins of diarrhoea, fever and neutrophilic leucocytosis in COVID-19 and the rationale to exclude Clostridium difficile infection in such patients.Key points. A 57-yo female patient was admitted in May 2020 with the complaints of 39 °C fever, general weakness, polymyalgia, diarrhoea to 3–4 times a day (mushy stool, no morbid inclusions). Initial diarrhoea was non-severe and likely triggered by the coronavirus infection. A background antibiotic and putative-immunosuppressive therapy proceeded with watery diarrhoea to 7–8 times a day and C. difficile toxins A and B detected in stool. The C. difficile infection relapsed on day 10 of vancomycin withdrawal and associated with elevated body temperature, diarrhoea and neutrophil leucocytosis; signs of colitis determined in ultrasound and CT. Exacerbation was successfully treated in a repeated metronidazole-combined vancomycin course.Conclusion. Patients with COVID-19 are at risk of clostridial colitis due to massive antibiotic, systemic glucocorticoid and biologics-based therapy they receive. The opportunistic bacterial infection of C. difficile often proceeds undetected due to its potential mirroring of COVID-19 presentation. A screening algorithm in COVID-19 patients with diarrhoea should imply steps for C. difficile detection.https://www.gastro-j.ru/jour/article/view/551sars-cov-2covid-19clostridium difficilediarrhoeaenterocolitis conflict of interest: the authors declare no conflict of interest |
| spellingShingle | A. A. Timofeeva Yu. O. Shulpekova V. M. Nechaev M. R. Skhirtladze <i>Сlostridium difficile</i> Infection in a COVID-19 Patient Российский журнал гастроэнтерологии, гепатологии, колопроктологии sars-cov-2 covid-19 clostridium difficile diarrhoea enterocolitis conflict of interest: the authors declare no conflict of interest |
| title | <i>Сlostridium difficile</i> Infection in a COVID-19 Patient |
| title_full | <i>Сlostridium difficile</i> Infection in a COVID-19 Patient |
| title_fullStr | <i>Сlostridium difficile</i> Infection in a COVID-19 Patient |
| title_full_unstemmed | <i>Сlostridium difficile</i> Infection in a COVID-19 Patient |
| title_short | <i>Сlostridium difficile</i> Infection in a COVID-19 Patient |
| title_sort | i сlostridium difficile i infection in a covid 19 patient |
| topic | sars-cov-2 covid-19 clostridium difficile diarrhoea enterocolitis conflict of interest: the authors declare no conflict of interest |
| url | https://www.gastro-j.ru/jour/article/view/551 |
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