Masayuki Hiraki1,2, Rei Suzuki3, Nobuo Tanaka3, Hiroki Fukunaga3, Yoshinori Kinoshita4, Hayato Kimura5, Shusaku Tsutsui6, Masaru Murata3, Shunji Morita3. 1. Department of Surgery, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyogo, 664-8540, Japan. hiraki-masayuki@kansaih.johas.go.jp. 2. Department of Surgery, Kansai Rosai Hospital, Japan Organization of Occupational Health and Safety, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan. hiraki-masayuki@kansaih.johas.go.jp. 3. Department of Surgery, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyogo, 664-8540, Japan. 4. Department of Respiratory Medicine, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyogo, 664-8540, Japan. 5. Department of Diagnostic Pathology, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyogo, 664-8540, Japan. 6. Department of Gastroenterology, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyogo, 664-8540, Japan.
Abstract
BACKGROUND: Clostridioides (Clostridium) difficile infection (CDI) has become an increasingly significant disease not only as healthcare-associated infection, but also as community-acquired (CA) infection worldwide. CDI caused by the NAP1/BI/027 strain is reported to be more severe, difficult to cure, and frequently associated with recurrences in North America and Europe. CASE PRESENTATION: A 68-year-old woman was referred to our hospital for continuous lower abdominal pain 4 weeks after eradication therapy against Helicobacter pylori. While she was treated with fasting on the suspicion of ischemic colitis, she experienced septic shock. Emergent subtotal proctocolectomy revealed fulminant pseudomembranous C. difficile colitis. The C. difficile isolate recovered from the patient was identified as ribotype 027, which has been reported to be uncommon in Japan. CONCLUSION: We report a rare case of CA fulminant pseudomembranous colitis caused by ribotype 027 C. difficile after H. pylori eradication therapy.
BACKGROUND:Clostridioides (Clostridium) difficileinfection (CDI) has become an increasingly significant disease not only as healthcare-associated infection, but also as community-acquired (CA) infection worldwide. CDI caused by the NAP1/BI/027 strain is reported to be more severe, difficult to cure, and frequently associated with recurrences in North America and Europe. CASE PRESENTATION: A 68-year-old woman was referred to our hospital for continuous lower abdominal pain 4 weeks after eradication therapy against Helicobacter pylori. While she was treated with fasting on the suspicion of ischemic colitis, she experienced septic shock. Emergent subtotal proctocolectomy revealed fulminant pseudomembranous C. difficilecolitis. The C. difficile isolate recovered from the patient was identified as ribotype 027, which has been reported to be uncommon in Japan. CONCLUSION: We report a rare case of CA fulminant pseudomembranous colitis caused by ribotype 027 C. difficile after H. pylori eradication therapy.