Clostridium difficile Diarrhea in Children: Diagnosis, Management, and Prevention

Jonathan D. Crews, MD

Disclosures

January 24, 2014

Evaluation of Suspected CDI in Children

The quintessential symptom of CDI in children is diarrhea -- the passage of 3 or more unformed stools in a 24-hour period. The severity of illness ranges from a mild, self-limiting diarrhea to profuse diarrhea accompanied by systemic symptoms. Hematochezia has been described in series of children with CDI.[15,16] Children with gastrointestinal symptoms but without diarrhea are unlikely to have CDI.

Children can experience severe disease from CDI. Complications are infrequent but include pseudomembranous colitis, pneumatosis intestinalis, toxic megacolon, gastrointestinal perforation, renal failure, and sepsis.[15,17] In a hospital-based study, 22% of children with CDI developed severe disease, whereas only 7% experienced a complication.[15] Severe CDI in children is probably less common in office-based settings, although this has not been studied. In contrast to adults, an increasing trend in CDI severity has not been observed in children.[5,6]

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