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Clostridium difficile-associated disease in children with solid tumors

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Abstract

Goals of work

The goal of this study was to describe the incidence of Clostridium difficile-associated disease (CDAD) in children with solid tumours.

Patients and methods

After documentation of a case of C. difficile-associated pseudomembranous colitis in a patient with neuroblastoma, the presence of C. difficile toxins A and B was prospectively tested in all children undergoing antineoplastic chemotherapy for solid tumours or lymphomas at the “G. Gaslini” Children Hospital in Genoa who presented abdominal pain.

Main results

From January 2005 to December 2006, nine (6%) out of 141 patients treated for solid tumours had C. difficile toxin A detected in their stools in the presence of abdominal symptoms including vomit, abdominal pain and diarrhoea. The majority of patients had a normal neutrophil count at onset of gastrointestinal disease No patient developed pseudomembranous colitis, and none died. All patients received antibiotics and/or antineoplastic drugs previously associated with CDAD.

Conclusions

CDAD may be a complication of children with solid tumours. Since this disease may be life threatening and cause epidemic clusters, this possibility must be kept in mind for the differential diagnosis of abdominal diseases in children with cancer, especially in absence of neutropenia.

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Authors and Affiliations

  1. Infectious Diseases Unit, G.Gaslini Children Hospital, Largo G.Gaslini, 5, 16147, Genoa, Italy

    Elio Castagnola, Ilaria Caviglia & Cristina Moroni

  2. Clinics of Pediatrics, G.Gaslini Children Hospital, Genoa, Italy

    Teresa Battaglia

  3. Laboratory of Mycrobiology, G.Gaslini Children Hospital, Genoa, Italy

    Roberto Bandettini

  4. Oncology Unit, G.Gaslini Children Hospital, Genoa, Italy

    Marilina Nantron & Alberto Garaventa

  5. Infection Control Team, G.Gaslini Children Hospital, Genoa, Italy

    Ivana Baldelli

Authors
  1. Elio Castagnola
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  2. Teresa Battaglia
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  3. Roberto Bandettini
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  4. Ilaria Caviglia
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  5. Ivana Baldelli
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  6. Marilina Nantron
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  7. Cristina Moroni
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  8. Alberto Garaventa
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Corresponding author

Correspondence to Elio Castagnola.

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Castagnola, E., Battaglia, T., Bandettini, R. et al. Clostridium difficile-associated disease in children with solid tumors. Support Care Cancer 17, 321–324 (2009). https://doi.org/10.1007/s00520-008-0507-0

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  • DOI: https://doi.org/10.1007/s00520-008-0507-0

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