Internal Medicine Residency Program, Wright State University School of Medicine, Dayton, OH, USA.
Internal Medicine Program at Miami Valley Hospital, Wright State University School of Medicine, Dayton, OH, USA.
Am J Case Rep. 2020 Nov 30;21:e928169. doi: 10.12659/AJCR.928169.
BACKGROUND Clostridioides difficile infection (CDI) is a common community-acquired and nosocomial infection that usually presents as colitis. C. difficile bacteremia (CDB) is a rare blood infection, with only a few cases recorded in the literature. We seek to expound on the current literature by detailing the clinical course of a patient with metastatic melanoma who developed CDB. CASE REPORT This case highlights the hospital course of a 51-year-old man admitted for a new onset of arrhythmia during the evaluation and management of a malignancy. The patient experienced hemodynamic collapse and rapid deterioration, which progressed to death. The etiology of death is thought to be septic shock due to CDB in the setting of multiple comorbidities. CONCLUSIONS The patient was predisposed to CDI because of the disruption of his intestinal milieu by the administration of a cephalosporin for the treatment of his suspected secondary bacterial peritonitis. His treatment with palliative radiation to his rectal mass placed him further at risk of CDI. We believe either of these could have contributed alone or synergistically to the development of his CDB.
艰难梭菌感染（CDI）是一种常见的社区获得性和医院获得性感染，通常表现为结肠炎。艰难梭菌菌血症（CDB）是一种罕见的血液感染，文献中仅记录了少数几例。我们旨在通过详细描述一名转移性黑色素瘤患者发生艰难梭菌菌血症的临床过程来阐述当前的文献。
本病例重点介绍了一名 51 岁男性的住院过程，他因在恶性肿瘤评估和管理过程中出现新发心律失常而入院。该患者经历了血流动力学崩溃和迅速恶化，最终导致死亡。死亡的病因被认为是由于艰难梭菌菌血症引起的感染性休克，同时合并多种合并症。
由于给予头孢菌素治疗疑似继发性细菌性腹膜炎而破坏了患者的肠道环境，因此该患者易发生 CDI。他因直肠肿块进行姑息性放疗，进一步增加了发生 CDI 的风险。我们认为，这些因素中的任何一个单独或协同作用都可能导致他发生艰难梭菌菌血症。
