Clostridium difficile Infection in a Very Young Infant with Pseudomembranous Colitis Noted on Endoscopy

Clostridium difficile infection rates have been rising within the last decade and more pediatric patients have been suffering from this type of infection. However, this bacterium is a well-known contaminant in the normal flora of the colon in patients under the age of 2 years, and therefore consensus guidelines have recommended against routine testing for this infection, unless clinically indicated. We present here a case of a very young infant who presented with symptoms of food refusal, poor weight gain, abdominal distention, and colitis noted on imaging. Endoscopic evaluation demonstrated the presence of pseudomembranous colitis, so the patient was treated with antibiotics against C. difficile and recovered fully. This case demonstrates the importance of keeping C. difficile colitis in your differential diagnosis, even at a very young age.