Clostridium difficile Bacteremia as a Rare Presentation of Polymicrobial Pyogenic Liver Abscesses and Its Management Challenges

Junghyun Lim; Catherine Zaw; Simon Abramson; Paola N Lichtenberger; Binu V John; Lorena Cuebas-Rosado

doi:10.1159/000531892

Clostridium difficile Bacteremia as a Rare Presentation of Polymicrobial Pyogenic Liver Abscesses and Its Management Challenges

Case Rep Gastroenterol. 2023 Sep 6;17(1):264-268. doi: 10.1159/000531892. eCollection 2023 Jan-Dec.

Authors

Junghyun Lim¹, Catherine Zaw², Simon Abramson³, Paola N Lichtenberger⁴, Binu V John⁵, Lorena Cuebas-Rosado⁶

Affiliations

¹ Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
² Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
³ Veterans Health Affairs National Teleradiology Program, Menlo Park, CA, USA.
⁴ Department of Infectious Disease, Bruce W. Carter VA Medical Center, Miami, FL, USA.
⁵ Division of Hepatology, Bruce W. Carter VA Medical Center, Miami, FL, USA.
⁶ Department of Medicine, Bruce W. Carter VA Medical Center, Miami, FL, USA.

Abstract

Extracolonic manifestations of Clostridium difficile have been rarely reported. We herein report a case of a 60-year-old immunocompetent man presenting with fever, nausea, abdominal pain, and loose stools for 2 weeks. Triple-phase liver computed tomography demonstrated pyogenic liver abscesses and portal pylephlebitis. Blood cultures grew C. difficile and Bacteroides fragilis, and liver abscess cultures grew Proteus mirabilis, Escherichia coli, and the viridans group Streptococci. Antibiotics coverage was selected to direct at all identified organisms. This demonstrates an unusual case of C. difficile bacteremia in a patient with polymicrobial pyogenic liver abscesses and pylephlebitis.

Keywords: Clostridium difficile; Liver abscess; Polymicrobial infection; Pylephlebitis.

Publication types

Case Reports

Grants and funding

No funding was received for this case report.