Clostridium difficile infection after ileostomy closure mimicking anastomotic leak. (6th July 2015)

• Record Type: Journal Article
• Authors: Almerie, Muhammad Qutayba; Culverwell, Adam; Mahon, Christopher
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-07-06
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2015-210112
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Clostridium difficile infection is linked to antibiotic exposure, with elderly and immunocompromised hospitalised patients being particularly at risk. The symptoms range from mild diarrhoea to life-threatening fulminant colitis. We describe an unusual presentation of C. difficile infection after closure of ileostomy in a healthy 60-year-old man with a history of low anterior resection and defunctioning ileostomy for rectal tumour. On the third day postoperatively, the patient developed left lower abdominal pain and profuse diarrhoea. With worsening symptoms and steadily increasing inflammatory markers over the following few days, concerns were raised about an anastomotic leak with pelvic abscess. CT of the abdomen/pelvis on day 7 surprisingly showed colitis in the neorectum/sigmoid colon. A stool test confirmed C. difficile infection.