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Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection

Clostridioides difficile (C. difficile)and coronavirus disease 2019 (COVID-19) infections can have overlapping symptoms. Recently, the association and outcomes of coinfection have been studied. We present the case of an 83-year-old lady with Parkinson’s disease (PD) who was admitted with pneumonia s...

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Autores principales: Duhan, Sanchit, Keisham, Bijeta, Salim, Ahlaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231867/
https://www.ncbi.nlm.nih.gov/pubmed/37265903
http://dx.doi.org/10.7759/cureus.38401
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author Duhan, Sanchit
Keisham, Bijeta
Salim, Ahlaa
author_facet Duhan, Sanchit
Keisham, Bijeta
Salim, Ahlaa
author_sort Duhan, Sanchit
collection PubMed
description Clostridioides difficile (C. difficile)and coronavirus disease 2019 (COVID-19) infections can have overlapping symptoms. Recently, the association and outcomes of coinfection have been studied. We present the case of an 83-year-old lady with Parkinson’s disease (PD) who was admitted with pneumonia secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. She was treated with empiric antibiotics ampicillin-sulbactam and azithromycin, along with antiviral therapy remdesivir and baricitinib, and dexamethasone. The patient developed severe C. difficile infection with a leukemoid reaction. She was treated with intravenous metronidazole and oral vancomycin without any improvement. Before she could receive a fecal microbiota transplant, her infection progressed to fulminant colitis, and she required emergent surgery. The patient developed several complications post-surgery and succumbed to the severe illness. Our patient’s multiple comorbidities and an underlying COVID-19 infection predisposed her to severe illness. This case emphasizes the long-standing discussion on antibiotic stewardship and encourages a debate on the role of immunosuppressant antiviral medications and underlying PD in predisposing patients to a severe C. difficile infection.
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spelling pubmed-102318672023-06-01 Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection Duhan, Sanchit Keisham, Bijeta Salim, Ahlaa Cureus Internal Medicine Clostridioides difficile (C. difficile)and coronavirus disease 2019 (COVID-19) infections can have overlapping symptoms. Recently, the association and outcomes of coinfection have been studied. We present the case of an 83-year-old lady with Parkinson’s disease (PD) who was admitted with pneumonia secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. She was treated with empiric antibiotics ampicillin-sulbactam and azithromycin, along with antiviral therapy remdesivir and baricitinib, and dexamethasone. The patient developed severe C. difficile infection with a leukemoid reaction. She was treated with intravenous metronidazole and oral vancomycin without any improvement. Before she could receive a fecal microbiota transplant, her infection progressed to fulminant colitis, and she required emergent surgery. The patient developed several complications post-surgery and succumbed to the severe illness. Our patient’s multiple comorbidities and an underlying COVID-19 infection predisposed her to severe illness. This case emphasizes the long-standing discussion on antibiotic stewardship and encourages a debate on the role of immunosuppressant antiviral medications and underlying PD in predisposing patients to a severe C. difficile infection. Cureus 2023-05-01 /pmc/articles/PMC10231867/ /pubmed/37265903 http://dx.doi.org/10.7759/cureus.38401 Text en Copyright © 2023, Duhan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Duhan, Sanchit
Keisham, Bijeta
Salim, Ahlaa
Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title_full Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title_fullStr Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title_full_unstemmed Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title_short Fulminant Clostridioides difficile Colitis With SARS-CoV-2 Infection
title_sort fulminant clostridioides difficile colitis with sars-cov-2 infection
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231867/
https://www.ncbi.nlm.nih.gov/pubmed/37265903
http://dx.doi.org/10.7759/cureus.38401
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