Libby Donice B, Bearman Gonzalo
Department of Medicine, Division of Infectious Diseases, Virginia Commonwealth University Medical Center, 1101 East Marshall Street, PO Box 980049, Richmond, VA 23298-0049, USA.
Int J Infect Dis. 2009 Sep;13(5):e305-9. doi: 10.1016/j.ijid.2009.01.014. Epub 2009 Apr 26.
Extracolonic Clostridium difficile infections have been infrequently reported. Extracolonic manifestations of C. difficile include bacteremia, intra-abdominal abscess, osteomyelitis, visceral abscess, empyema, reactive arthritis, and small bowel disease with formation of pseudomembranes on ileal mucosa. Most cases of extracolonic C. difficile have been preceded by gastrointestinal disease, either C. difficile colitis or surgical and anatomical disruption of the colon. Bacteremia due to C. difficile has previously been described in 14 patients with underlying gastrointestinal processes. We report a unique case of monomicrobial C. difficile bacteremia in a young woman with an underlying hematologic malignancy. The patient lacked gastrointestinal symptoms or radiologic findings suggestive of colitis or ongoing gastrointestinal pathology.
结肠外艰难梭菌感染的报道较少。艰难梭菌的结肠外表现包括菌血症、腹腔内脓肿、骨髓炎、内脏脓肿、脓胸、反应性关节炎以及小肠疾病伴回肠黏膜假膜形成。大多数结肠外艰难梭菌病例之前都有胃肠道疾病,要么是艰难梭菌结肠炎,要么是结肠的手术和解剖结构破坏。先前已有14例患有潜在胃肠道疾病的患者出现艰难梭菌所致菌血症的报道。我们报告了一例年轻女性单微生物艰难梭菌菌血症的独特病例,该女性患有潜在血液系统恶性肿瘤。患者没有提示结肠炎或持续胃肠道病变的胃肠道症状或影像学表现。