Article in Japanese

A 2-year-old child with Clostridioides difficile infection presenting with bloody stools

Mamiko Takebe^1）, Tatsunori Hokosaki^1）, Hiromi Tadaki^1）, Yoshiki Hara^1）, Hiromi Shioya^1）, Hiroyuki Shimizu^2）

Clostridioides difficile （CD） infection is a common cause of antibiotic-associated diarrhea, but its epidemiology and clinical course differ between adults and children, with many aspects still unclear in pediatric cases. This study reported a case of CD infection in a young child presenting with bloody stools. The patient was a 2-year-old boy born at 24 weeks and 2 days of gestation, with a birth weight of 513 g and a nasogastric tube. He was admitted to the hospital for aspiration pneumonia and started on broad-spectrum antibiotics. On the third day, he developed a fever and bloody stools. The rapid CD test was positive for antigen, but negative for toxin. Nevertheless, based on clinical suspicion of CD infection, oral vancomycin was administered, which promptly reduced his fever and resolved the bloody stools. Later, toxin was detected in a culture specimen, confirming the diagnosis of CD infection.
In treating pediatric CD infection, it is crucial to recognize the differences between pediatric and adult cases and to conduct appropriate diagnostic and therapeutic approaches based on accumulating understanding of the disease’s epidemiology and clinical course.

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1）Department of Pediatrics, Yokohama Medical Center
2）Department of Clinical Laboratory, Fujisawa City Hospitalr

Key words	Clostridioides difficile, CD infection, bloody stool, pediatrics
Received	October 19, 2024
Accepted	December 21, 2024

37 (1)：25─32,2025