Unusual Presentation of Clostridium Difficile Infection in a Patient with Inflammatory Bowel Disease

Sattar  Jafari; Shalaleh  Aghaei; Behnam  Sajedi; Samira  Akbarieh

doi:10.18502/crcp.v9i5.18455

Sattar Jafari Department of Gastroenterology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Shalaleh Aghaei Department of Internal Medicine, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Behnam Sajedi Department of Gastroenterology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
Samira Akbarieh Department of Infectious and Tropical Diseases, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

DOI: https://doi.org/10.18502/crcp.v9i5.18455

Keywords: Clostridium difficile; Inflammatory bowel diseases; Ulcerative colitis; Pseudomembranous colitis

Abstract

Clostridium difficile infection (CDI) is commonly associated with nosocomial diarrhea;however, certain atypical presentations can challenge its diagnosis. We report a caseof CDI in a 25-year-old male with inflammatory bowel disease (IBD), presenting withunusual clinical features, including abdominal distension, lower extremity edema,and persistent non-bloody diarrhea. Diagnostic uncertainty arose due to the patient’sprior IBD diagnosis and atypical symptoms. Nevertheless, CDI was confirmed throughstool toxin assay and colonoscopy findings of pseudomembranes. Treatment with oralvancomycin resulted in complete symptom resolution, underscoring the importanceof considering CDI in cases with atypical symptoms. Prompt diagnosis is essential foreffective management and prevention of complications.