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GASTROENTERITA ACUTA CU CLOSTRIDIUM DIFFICILE LA UN COPIL MIC CU INTOLERANTA EREDITARA LA LACTOZA
Acute gastroenteritis with Clostridium difficile is insufficiently studied in the specialty literature due to its small incidence at this age, with increased rates of morbidity and mortality. We present the case of a 1 year and 10 month-old child, diagnosed with hereditary lactose intolerance in the neonatal period, admitted in the Pediatrics Clinic I, Targu-Mures, for vomiting, loss of appetite, decreased consistency stools, with a bed smell, with bacterial infection signs in the blood tests and slowly favorable evolution under treatment with cephalosporin. The patient is readmitted after 1 day from discharge with the reappearance of bad smell stools and loss of appetite, with unfavorable evolution after administering a 3rd generation cephalosporin, thus we raise the suspicion of infection with Clostridium difficile, confirmed by the identification of toxins in the stools, with favorable evolution under treatment for anaerobe germs (metronidazole). The particularity of the case consists in the development of a gastroenteritis with Clostridium difficile in a small child (1 year and 10 months), known with retardation in the neuro-psychomotor and language development, repeated episodes of hypoglycemia, with hereditary lactose intolerance which represented a challenge in establishing the diagnosis.
Cuvinte cheie: Clostridium difficile, child, gastroenteritis, hereditary lactose intolerance