Recurrent bacteremia and liver abscess caused by Clostridium difficile

Hiroshi Morioka, Mitsutaka Iguchi, Teiji Kuzuya, Hiroshige Mikamo, Tetsuya Yagi

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Clostridium difficile bacteremia (CDB) and liver abscess is a quite rare presentation of C. difficile infection. Patients concerns: A 74-year-old male with primary biliary cirrhosis and hepatocellular carcinoma who underwent transarterial chemoembolization (TACE) developed a high fever on post-TACE day 14. Intravenous ceftriaxone and following meropenem were administered, however, his clinical response was poor. On post-TACE day 24, 2 sets of blood culture were taken due to elevation of C-reactive protein levels. Diagnosis: CDB, caused by bacterial translocation. Interventions: Intravenous vancomycin and oral metronidazole were administered for two weeks. Outcomes: One month after recurrent CDB, the patient was re-admitted due to a liver abscess at the same site of TACE. C. difficile was isolated from the liver abscess and the patient received 6 weeks of oral metronidazole treatment. CDB and liver abscess have not recurred since completion of antibiotic treatment. Lessons: The spore-forming ability of C. difficile may contributed to the recurrent CDB episodes and liver abscess formation in necrotic liver tissue following TACE, and long-term metronidazole therapy was considered to be effective to C. difficile liver abscess.

Original languageEnglish
Article numbere7969
JournalMedicine (United States)
Volume96
Issue number35
DOIs
Publication statusPublished - 01-09-2017

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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