Clostridioides difficile Bacteraemia and Septic Arthritis in a Sickle Cell Disease Patient

Extra-colonic Clostridioides difficile infection is rare. Here we describe a sickle cell disease patient with avascular necrosis who presented with persistent bacteraemia due to C. difficile and septic arthritis in a native knee joint, which responded very well to medical and surgical treatment but recurred multiple times within weeks of the cessation of antibiotics. LEARNING POINTS: Clostridioides difficile can rarely have a wide variety of extra-colonic manifestations. Patients with sickle cell disease may have a higher predisposition to extra-colonic C. difficile infection (CDI) with high mortality and recurrence rates. Intravenous metronidazole or vancomycin are the most widely used treatments for extra-colonic CDI.