Clostridium difficile

Classically causes pseudomembranous colitis.  A soil anaerobe, spore producing.

In children, most will have had antibiotics within past 4-12 weeks, other risk factors are past and/or prolonged hospitalization.  Many comorbid conditions associated esp cancer, inflammatory bowel disease. Clindamycin was classically the antibiotic most associated but any will do.

There may be fever and abdominal pain.  Colitis can mimic (or exacerbate) IBD.  Severe infection unusual.  Markers established in adults for severe infection resulting in colectomy or transfer to ICU have not been shown to correlate in kids.

“Pseudomembranes” are a non-specific endoscopy finding.  Not always tested for automatically by lab, you may need to specify. Toxin test (not 100% sensitive).

Current Opinion in Pediatrics. 26(5):568-72, 2014 Oct. PMID 25032717