Pseudomembraneous clostridium after autologous bone marrow transplantation.

Abstract

Clostridium difficile (C. difficile) pseudomembraneous colitis was diagnosed in a 13-year-old boy with Hodgkin's disease 3 months after autologous bone marrow transplantation. Hematopoiesis was fully reconstituted at the time. C. difficile infection occurred after gall bladder empyema had been treated conservatively with i.v. antibiotics and prophylactic 4-week administration of oral amoxicillin. C. difficile colitis was diagnosed early and intensive supportive therapy combined with administration of i.v. and subsequently oral vancomycin therapy failed. It is a phenomenon rarely seen and successful eradication of the clostridium infection was only achieved by a combination of higher dose vancomycin with metronidazole. During the post-colitis recovery the patient experienced a relapse of Hodgkin's disease and died following further surgical intervention 137 days post-transplantation.

• Authors: P Kavan, M Sochor, O Nyc, O Lochmann, J Koutecky, P J Skala, L K McClain
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 21 Issue 5 Pg. 521-3 (Mar 1998) ISSN: 0268-3369 [Print] England
• PMID: 9535046 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antitrichomonal Agents
• Metronidazole
• Vancomycin

Topics

• Adolescent
• Anti-Bacterial Agents (therapeutic use)
• Antitrichomonal Agents (therapeutic use)
• Bone Marrow Transplantation (adverse effects)
• Clostridioides difficile
• Enterocolitis, Pseudomembranous (drug therapy, etiology)
• Hematopoiesis
• Hodgkin Disease (complications, therapy)
• Humans
• Male
• Metronidazole (therapeutic use)
• Transplantation, Autologous
• Vancomycin (therapeutic use)