A CLINICAL CASE OF RECURRENT CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA IN A CHILD

Abstract

Introduction. Clostridium difficile is the most important infectious aetiology of antibiotic-associated diarrhea. Today, in the era of pandemics and numerous epidemics that have faced the humanity, antibiotic therapy is one of the most common medical practices. However, the careless use and irrational prescription of antibiotics increase the risk of their negative impact on the human body and steadily approach antibiotic resistance. American Academy of Pediatrics reports an increase in the incidence of Clostridium difficile infection in children; a wide spectrum of disease severity can occur, ranging from asymptomatic carriage to severe recurrent diarrhea. Annually 20 thousand cases of Clostridium difficile infection are registered among patients in the pediatric cohort аccording to the American Academy of Pediatrics. The relevance of the topic is due to the increase in the incidence of Clostridium difficile-associated diarrhea, which is a result of irrational antibiotic therapy. The aim of the study: to increase the awareness and vigilance of medical workers regarding the possibility of recurrent Clostridium difficile-associated diarrhea in children based on the demonstration of a clinical case. Materials and methods. The results of examination, clinical observation and analysis of clinical case of enterocolitis caused by Clostridium difficile in a 5-year-old child are given. Results and discussion. A 5-year-old patient was hospitalised with complaints of increased body temperature, blood-tinged stools, abdominal pain, lethargy, and decreased appetite. Clostridium difficile toxin A and toxin B were detected by the PCR method during stool analysis for the detection of clostridia. The patient was discharged from the clinic with an improvement in his general condition after the treatment, on the background of clinical recovery. But later he was hospitalized twice to the the Kyiv City Children's Clinical Infectious Hospital with a recurrence of Clostridium difficile-associated diarrhea and positive Polymerase chain reaction test results. Conclusions. Circumspection of the possibility of recurrent Clostridium difficile-associated diarrhea is important in the diagnosis of infectious diseases.