scholarly journals Clostridium difficile colitis complicating Kawasaki disease in children: Two case reports

2018 ◽  
Vol 6 ◽  
pp. 2050313X1878174
Author(s):  
Maria Belen Rojas Gallegos ◽  
Chaowapong Jarasvaraparn ◽  
Lynn Batten ◽  
Haidee Custodio ◽  
David A Gremse
Keyword(s):  
Abdominal Pain ◽  
Clostridium Difficile ◽  
Kawasaki Disease ◽  
Case Reports ◽  
Unknown Etiology ◽  
Fulminant Colitis ◽  
Asymptomatic Carriage ◽  
Associated Symptoms ◽  
Clostridium Difficile Colitis ◽  
High Index Of Suspicion

Clostridium difficile infection is increasingly diagnosed in children with a wide clinical spectrum ranging from asymptomatic carriage to fulminant colitis. Symptomatic patients typically present with diarrhea, with or without blood, fever, and abdominal pain. Kawasaki disease, a vasculitis of unknown etiology, occurs primarily in young children. Establishing the diagnosis of Kawasaki disease can be challenging given the lack of a confirmatory diagnostic test or pathognomonic features as well as the appearance of symptoms over time rather than simultaneously. In addition, commonly occurring nonspecific associated symptoms, such as diarrhea and abdominal pain, may confound the clinical presentation. We present two cases of children with Kawasaki disease presenting with fever and Clostridium difficile colitis to illustrate the importance of keeping a high index of suspicion for Kawasaki disease.

scholarly journals Primary Peritonitis: An Index Case of Mycoplasma hominis Infection in a Healthy Female

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Sabrina Drexel ◽  
Daniel Tseng
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Fluid ◽  
Case Reports ◽  
Uterine Fibroids ◽  
Healthy Woman ◽  
Systemic Infection ◽  
Mycoplasma Hominis ◽  
Unknown Etiology ◽  
Primary Peritonitis ◽  
First Case

Introduction. Primary peritonitis in healthy immunocompetent individuals is rare. Several case reports of Streptococcus species causing peritonitis have been described. Here, we present the first case of Mycoplasma hominis as the cause of primary peritonitis in a healthy woman. Case Report. A 42-year-old female with history of uterine fibroids was admitted with abdominal pain and intraperitoneal fluid of unknown etiology. She was initially managed nonoperatively and empirically treated with broad spectrum antibiotics. Blood and urine cultures were unrevealing. Increasing abdominal pain and peritoneal fluid prompted diagnostic laparoscopy which revealed a dense fibrinous exudate covering the entire peritoneal cavity. Peritoneal fluid and biopsies were sent for cytology and culture. The peritoneal fluid was eventually sent for 16 s ribosomal analysis, which discovered Mycoplasma hominis RNA. Her antibiotics were narrowed, and she eventually made a full recovery. Discussion. M. hominis is a rare source of systemic infection but has been known to colonize the urogenital tract and cause localized infections. This is the first presentation of M. hominis causing primary peritonitis in a healthy immunocompetent female. Multidisciplinary management of these patients is critical to achieve a timely diagnosis. Surgical exploration is often unavoidable to rule out secondary peritonitis.

Clostridium Difficile Infection in Inflammatory Bowel Disease Patients

2019 ◽  
Vol 19 (7) ◽  
pp. 929-935
Author(s):  
Abdulmajeed A. Albarrak ◽  
Bhupinder S. Romana ◽  
Suleyman Uraz ◽  
Mohamad H. Yousef ◽  
Alhareth A. Juboori ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Bowel Disease ◽  
Health Care Organizations ◽  
Fecal Microbiota ◽  
Fecal Microbiota Transplant ◽  
Expert Review ◽  
Inflammatory Bowel ◽  
High Index Of Suspicion

Background:The rising incidence of Clostridium difficile infection (CDI) in the general population has been recognized by health care organizations worldwide. The emergence of hypervirulent strains has made CDI more challenging to understand and treat. Inflammatory bowel disease (IBD) patients are at higher risk of infection, including CDI.Objective:A diagnostic approach for recurrent CDI has yet to be validated, particularly for IBD patients. Enzyme immunoassay (EIA) for toxins A and B, as well as glutamate dehydrogenase EIA, are both rapid testing options for the identification of CDI. Without a high index of suspicion, it is challenging to initially differentiate CDI from an IBD flare based on clinical evaluation alone.Methods:Here, we provide an up-to-date review on CDI in IBD patients. When caring for an IBD patient with suspected CDI, it is appropriate to empirically treat the presumed infection while awaiting further test results.Results:Treatment with vancomycin or fidaxomicin, but not oral metronidazole, has been advocated by an expert review from the clinical practice update committee of the American Gastroenterology Association. Recurrent CDI is more common in IBD patients compared to non-IBD patients (32% versus 24%), thus more aggressive treatment is recommended for IBD patients along with early consideration of fecal microbiota transplant.Conclusion:Although the use of infliximab during CDI has been debated, clinical experience exists supporting its use in an IBD flare, even with active CDI when needed.

scholarly journals Early anti IL-1 treatment replaces steroids in refractory Kawasaki disease: clinical experience from two case reports

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110025
Author(s):  
Maria Vincenza Mastrolia ◽  
Giulia Abbati ◽  
Claudia Signorino ◽  
Ilaria Maccora ◽  
Edoardo Marrani ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Evidence ◽  
Case Reports ◽  
Therapeutic Option ◽  
Intravenous Immunoglobulins ◽  
Second Line Therapy ◽  
Coronary Artery Aneurysms ◽  
Coronary Arteritis ◽  
Line Therapy ◽  
Prior Use

Refractory Kawasaki disease (KD) is related to a major risk of coronary arteries abnormalities and its treatment is not standardized. In this regard, anakinra (ANA), an interleukin (IL)-1 receptor antagonist, represents an emerging therapeutic option. We report two cases of children, diagnosed with KD, nonresponsive to two doses of intravenous immunoglobulins, successfully treated with ANA, without a prior use of steroids. Patient 2 developed a coronary dilatation, that improved significantly after ANA therapy. Our experience highlights IL-1 blockade effectiveness in reducing KD inflammation and suggests ANA adoption as second-line therapy, with a timesaving and steroid-sparing strategy. Our results, combined with the evidence of the IL-1 key role in KD and coronary arteritis pathogenesis and to the recent clinical evidence reported by the KAWAKINRA trial, encourage an earlier recourse to ANA in patients with refractory KD, in order to fight inflammation, and to treat and prevent the development of coronary artery aneurysms. Further studies are needed to better define the place of IL-1 blockade in KD step-up treatment.

Effect of Bismuth Subsalicylate on Clostridium difficile Colitis in Hamsters

1990 ◽  
Vol 12 (Supplement_1) ◽  
pp. S57-S58 ◽  
Author(s):  
Te-Wen Chang ◽  
Mei-Yan Dong ◽  
Sherwood L. Gorbach
Keyword(s):  
Clostridium Difficile ◽  
Bismuth Subsalicylate ◽  
Clostridium Difficile Colitis

Fulminant colitis from Clostridium difficile infection, the epidemic strain ribotype 027, in Japan

2014 ◽  
Vol 20 (6) ◽  
pp. 380-383 ◽  
Author(s):  
Itaru Nakamura ◽  
Tetsuo Yamaguchi ◽  
Ayaka Tsukimori ◽  
Akihiro Sato ◽  
Shinji Fukushima ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Epidemic Strain ◽  
Fulminant Colitis ◽  
Ribotype 027

Therapy of acute Kawasaki disease

1991 ◽  
Vol 1 (3) ◽  
pp. 254-255
Author(s):  
Jane W. Newburger
Keyword(s):  
Myocardial Infarction ◽  
Early Childhood ◽  
Kawasaki Disease ◽  
Sudden Death ◽  
Cervical Lymphadenopathy ◽  
Unknown Etiology ◽  
Acute Kawasaki Disease ◽  
Arterial Insufficiency ◽  
Infancy And Early Childhood ◽  
Arterial Aneurysms

Kawasaki disease is an acute vasculitis of unknown etiology that occurs predominantly in infancy and early childhood. It is characterize by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy.1,2 Coronary arterial aneurysms, or ectasia, develop in approximately 15 to 25% of children with the disease, and may lead to myocardial infarction, sudden death, or chronic coronary arterial insufficiency.2–4

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