Clostridium difficile causing acute renal failure: case presentation and review.

Abstract

AIM:

Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population. Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.

METHODS:

In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-year-old patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.

RESULTS:

The link between Clostridium difficile-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.

CONCLUSION:

Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications.

• Authors: Jasmin Arrich, Gottfried-H Sodeck, Gurkan Sengolge, Christoforos Konnaris, Marcus Mullner, Anton-N Laggner, Hans Domanovits
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 11 Issue 8 Pg. 1245-7 (Feb 28 2005) ISSN: 1007-9327 [Print] United States
• PMID: 15754415 (Publication Type: Journal Article, Review, Systematic Review)

Chemical References

• Anti-Infective Agents
• Metronidazole

Topics

• Acute Kidney Injury (microbiology, therapy)
• Aged
• Aged, 80 and over
• Anti-Infective Agents (administration & dosage)
• Clostridioides difficile
• Enterocolitis, Pseudomembranous (complications, drug therapy)
• Humans
• Male
• Metronidazole (administration & dosage)