Junghyun Lim, Catherine Zaw, Simon Abramson, Paola N Lichtenberger, Binu V John, Lorena Cuebas-Rosado
{"title":"<i>Clostridium difficile</i> Bacteremia as a Rare Presentation of Polymicrobial Pyogenic Liver Abscesses and Its Management Challenges.","authors":"Junghyun Lim, Catherine Zaw, Simon Abramson, Paola N Lichtenberger, Binu V John, Lorena Cuebas-Rosado","doi":"10.1159/000531892","DOIUrl":null,"url":null,"abstract":"<p><p>Extracolonic manifestations of <i>Clostridium difficile</i> have been rarely reported. We herein report a case of a 60-year-old immunocompetent man presenting with fever, nausea, abdominal pain, and loose stools for 2 weeks. Triple-phase liver computed tomography demonstrated pyogenic liver abscesses and portal pylephlebitis. Blood cultures grew <i>C. difficile</i> and <i>Bacteroides fragilis</i>, and liver abscess cultures grew <i>Proteus mirabilis</i>, <i>Escherichia coli</i>, and the viridans group <i>Streptococci</i>. Antibiotics coverage was selected to direct at all identified organisms. This demonstrates an unusual case of <i>C. difficile</i> bacteremia in a patient with polymicrobial pyogenic liver abscesses and pylephlebitis.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":"17 1","pages":"264-268"},"PeriodicalIF":0.5000,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624945/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000531892","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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Abstract
Extracolonic manifestations of Clostridium difficile have been rarely reported. We herein report a case of a 60-year-old immunocompetent man presenting with fever, nausea, abdominal pain, and loose stools for 2 weeks. Triple-phase liver computed tomography demonstrated pyogenic liver abscesses and portal pylephlebitis. Blood cultures grew C. difficile and Bacteroides fragilis, and liver abscess cultures grew Proteus mirabilis, Escherichia coli, and the viridans group Streptococci. Antibiotics coverage was selected to direct at all identified organisms. This demonstrates an unusual case of C. difficile bacteremia in a patient with polymicrobial pyogenic liver abscesses and pylephlebitis.
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