tetano
Editor, Senior Moderator
Ann R Coll Surg Engl
. 2020 Aug 17;e1-e4.
doi: 10.1308/rcsann.2020.0166. Online ahead of print.
Severe Clostridium difficile colitis as potential late complication associated with COVID-19
J P?ramo-Zunzunegui[SUP] 1 [/SUP], I Ortega-Fern?ndez[SUP] 1 [/SUP], P Calvo-Espino[SUP] 1 [/SUP], C Diego-Hern?ndez[SUP] 2 [/SUP], I Ariza-Ibarra[SUP] 1 [/SUP], L Otazu-Canals[SUP] 1 [/SUP], J E Dan?s-Grases[SUP] 1 [/SUP], A Menchero-S?nchez[SUP] 1 [/SUP]
Affiliations
Abstract
Spain has been one of the most affected countries by the COVID-19 outbreak. After the high impact of the pandemic, a wide clinical spectrum of late complications associated with COVID-19 are being observed. We report a case of a severe Clostridium difficile colitis in a post-treatment and recovered COVID-19 patient. A 64-year-woman with a one-month hospital admission for severe bilateral pneumonia associated with COVID-19 and 10 days after discharge presented with diarrhoea and abdominal pain. Severe C. difficile-associated colitis is diagnosed according to clinical features and CT findings. An urgent pancolectomy was performed due to her bad response to conservative treatment. Later evolution slowly improved to recovery. C. difficile-associated colitis is one of the most common hospital-acquired infections. Significant patient-related risk factors for C. difficile infection are antibiotic exposure, older age, and hospitalisation. Initial therapeutic recommendations in our country included administration broad-spectrum antibiotics to all patients with bilateral pneumonia associated with SARS-CoV-2. These antibiotics are strongly associated with C. difficile infection. Our patient developed a serious complication of C. difficile due to the use of broad-spectrum antibiotics. The appearance of late digestive symptoms in patients diagnosed and treated for COVID-19 should alert clinicians to the possibility of C. difficile infection. The updated criteria for severe colitis and severe C. difficile infection should be considered to ensure an early effective treatment for the complication.
Keywords: 2019 Novel coronavirus disease; COVID-19; Colitis; Respiratory diseases; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Spain.
. 2020 Aug 17;e1-e4.
doi: 10.1308/rcsann.2020.0166. Online ahead of print.
Severe Clostridium difficile colitis as potential late complication associated with COVID-19
J P?ramo-Zunzunegui[SUP] 1 [/SUP], I Ortega-Fern?ndez[SUP] 1 [/SUP], P Calvo-Espino[SUP] 1 [/SUP], C Diego-Hern?ndez[SUP] 2 [/SUP], I Ariza-Ibarra[SUP] 1 [/SUP], L Otazu-Canals[SUP] 1 [/SUP], J E Dan?s-Grases[SUP] 1 [/SUP], A Menchero-S?nchez[SUP] 1 [/SUP]
Affiliations
- PMID: 32803988
- DOI: 10.1308/rcsann.2020.0166
Abstract
Spain has been one of the most affected countries by the COVID-19 outbreak. After the high impact of the pandemic, a wide clinical spectrum of late complications associated with COVID-19 are being observed. We report a case of a severe Clostridium difficile colitis in a post-treatment and recovered COVID-19 patient. A 64-year-woman with a one-month hospital admission for severe bilateral pneumonia associated with COVID-19 and 10 days after discharge presented with diarrhoea and abdominal pain. Severe C. difficile-associated colitis is diagnosed according to clinical features and CT findings. An urgent pancolectomy was performed due to her bad response to conservative treatment. Later evolution slowly improved to recovery. C. difficile-associated colitis is one of the most common hospital-acquired infections. Significant patient-related risk factors for C. difficile infection are antibiotic exposure, older age, and hospitalisation. Initial therapeutic recommendations in our country included administration broad-spectrum antibiotics to all patients with bilateral pneumonia associated with SARS-CoV-2. These antibiotics are strongly associated with C. difficile infection. Our patient developed a serious complication of C. difficile due to the use of broad-spectrum antibiotics. The appearance of late digestive symptoms in patients diagnosed and treated for COVID-19 should alert clinicians to the possibility of C. difficile infection. The updated criteria for severe colitis and severe C. difficile infection should be considered to ensure an early effective treatment for the complication.
Keywords: 2019 Novel coronavirus disease; COVID-19; Colitis; Respiratory diseases; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Spain.