Volume 16, Number 8—August 2010
CME ACTIVITY - Synopsis
Clostridium difficile Bacteremia, Taiwan1
|Patient no.||Age, y/sex||Clinical signs and symptoms||Sources of bacteremia||Coexisting condition(s)||Copathogen(s)||Clostridial toxin assay result||Treatment/ outcome|
|1||69/F||Dead on arrival||Primary bacteremia||Liver cirrhosis||None||Positive||None/died|
|2||38/M||Abdominal pain||IAI (primary peritonitis)||Wilson disease||None||Negative||Cefmetazole for 22 d/died|
|3||65/F||Fever, abdominal pain||IAI (secondary peritonitis)||Perforated peptic ulcer with exploratory laparotomy||None||NA||Metronidazole† for 10 d/died|
|4||58/M||Fever, abdominal pain||IAI (primary peritonitis)||Liver cirrhosis||None||Negative||Metronidazole† for 12 d/survived|
|5||12/M||Fever, dyspnea||Primary bacteremia||Biliary atresia, liver transplantation||None||Negative||Piperacillin- tazobactam and vancomycin† for 15 d/survived|
||Ceftazidime and gentamicin for 13 d; vancomycin† for 10 d/survived
|7||45/M||Abdominal pain||Primary bacteremia||Liver cirrhosis||Coagulase- negative Staphylococcus spp.||Positive||Ceftriaxone for 3 d/died|
|8||83/M||Fever, bloody stool||Primary bacteremia||Gastrointestinal bleeding, hypovolemic shock||Escherichia coli||Negative||Imipenem for 1 d/died|
|9||87/F||Bloody stool||Primary bacteremia||Congestive heart failure, end-stage renal disease, pseudomembranous colitis||Pseudomonas aeruginosa, Enterococcus faecium, E. coli, ESBL–Klebsiella oxytoca||Positive||Vancomycin† and meropenem for 7 d/survived|
|10||80/F||Bloody stool||Primary bacteremia||Liver cirrhosis, pseudomembranous colitis||Coagulase- negative Staphylococcus spp.||Positive||Metronidazole† for 13 d/survived|
|11||66/F||Fever, lower gastrointestinal bleeding, abdominal pain||SSTI/septic arthritis||Femoral neck fracture (received total hip replacement with prosthetic infections), chronic kidney disease||Enterobacter cloacae||Negative||Debridement, cefepime and metronidazole† for 12 d/survived|
|12||75/F||Fever, chills, nausea, vomiting, abdominal pain||IAI (primary peritonitis)||Lymphoma, biliary tract infection||K. pneumoniae, Clostridium perfringens||NA||Cefepime for 10 d and metronidazole† for 7 d/survived|
* IAI, intra-abdominal infection; NA, not available; SSTI, skin and soft tissue infection; ESBL, extended-spectrum β-lactamase.
†In vitro active against C. difficile.
Page created: March 30, 2011
Page updated: March 30, 2011
Page reviewed: March 30, 2011
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