Non-Clostridium difficile Bacterial Infection in an Acute Flare of Crohn's Disease: A Case Report and Literature Review.

Abstract

Abstract: Crohn's disease is a chronic inflammatory condition affecting any part of the gastrointestinal tract. Acute exacerbations pose a diagnostic challenge due to the difficulty in distinguishing active Crohn's disease from other causes, particularly infections. While Clostridium difficile infection is well-documented and typically screened for in symptomatic Crohn's patients, other enteric infections are often under-recognized and lack sufficient evidence. We report the case of a 17-year-old male with known colonic Crohn's disease who presented with a five-day history of fever and diarrhea. Initial treatment with ciprofloxacin was ineffective, suggesting a quinolone-resistant pathogen. Traditional diagnostic approaches, including stool cultures, failed to identify the pathogen. However, subsequent multiplex polymerase chain reaction testing of stool samples identified Campylobacter species, and signi-ficant clinical improvement was observed following azithromycin therapy. This case underscores the importance of considering non-Clostridium difficile infections in the differential diagnosis of Crohn's disease flares and highlights the clinical utility of multiplex polymerase chain reaction in rapidly identifying resistant pathogens. Implementing such molecular diagnostics is crucial for improving patient outcomes.