Clostridium difficile infection following colon subtotal resection in a patient with gallstones: A case report and review of literature  

作　　者：Feng Ke Zhen-Hua Dong Fan Bu Cheng-Nan Li Qi-Tong He Zhi-Cheng Liu Ji Lu Kai Yu Da-Guang Wang He-Nan Xu Chang-Tao Ye 

机构地区：[1]Department of General Surgery,Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130000,Jilin Province,China [2]Department of Gastrointestinal Surgery,The First Hospital of Jilin University,Changchun 130061,Jilin Province,China [3]Department of Plastic and Aesthetic Surgery,The First Hospital of Jilin University,Changchun 130061,Jilin Province,China [4]Department of Encephalopathy Rehabilitation,Chaoyi Hospital,Yanbian Korean Autonomous Prefecture,Yanji 133000,Jilin Province,China [5]Department of Urology,The First Hospital of Jilin University,Changchun 130061,Jilin Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第9期3048-3056,共9页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Clostridium difficile(C.difficile)infection(CDI)is a rare clinical disease caused by changes in the intestinal microenvironment,which has a variety of causes and a poor prognosis,and for which there is no standardized clinical treatment.CASE SUMMARY A patient experienced recurrent difficulty in bowel movements over the past decade.Recently,symptoms worsened within the last ten days,leading to a clinic visit due to constipation.The patient was subsequently referred to our depart-ment.Preoperatively,the patient was diagnosed with obstructed colon accom-panied by gallstones.Empirical antibiotics were administered both before and after surgery to prevent infection.On the fourth day post-surgery,symptoms of CDI emerged.Stool cultures confirmed the presence of C.difficile DNA.Treatment involved a combination of vancomycin and linezolid,resulting in the patient's successful recovery upon discharge.However,the patient failed to adhere to the prescribed medication after discharge and was discovered deceased during a follow-up two months later.CONCLUSION CDI is the leading cause of nosocomial post-operative care,with limited clinical cases and poor patient prognosis,and comprehensive clinical treatment guidelines are still lacking.This infection can be triggered by a variety of factors,including intestinal hypoxia,inappropriate antibiotic use,and bile acid circulation disorders.In patients with chronic bowel disease and related etiologies,prompt preoperative attention to possible CDI and preoperative bowel preparation is critical.Adequate and prolonged medication should be maintained in the treatment of CDI to prevent recurrence of the disease.

关 键 词：CHOLECYSTOLITHIASIS Clostridium difficile Bile acid circulation Intestinal microenvironment Case report 

分 类 号：R735.35[医药卫生—肿瘤]