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Clostridioides difficile Infection following Procalcitonin-guided Antibiotic Therapy for COVID-19

Authors

  • Anton G. Elepaño, MD Philippine General Hospital, University of the Philippines Manila https://orcid.org/0000-0002-8709-135X (##common.opensInNewWindow##)
  • Jonnel B. Poblete, MD Philippine General Hospital, University of the Philippines Manila
  • A. Nico Nahar I. Pajes, MD Philippine General Hospital, University of the Philippines Manila
  • Aldrin B. Loyola, MD Philippine General Hospital, University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.vi0.5443

Keywords:

COVID-19 Clostridioides difficile antibiotic-associated colitis

Abstract

We present a case of a 50-year-old man with chronic kidney disease (CKD) presenting with acute diarrhea and fever. He was admitted a month prior for COVID-19, where he received antibiotics for radiographic findings of pneumonia and elevated procalcitonin. In the emergency department, his stool sample tested positive for Clostridioides difficile antigen and toxin. He was given oral vancomycin and intravenous metronidazole for fulminant C. difficile infection and was discharged with resolution of symptoms. This case documents a potential risk associated with routine antibiotic use during the pandemic and the pitfalls in interpreting procalcitonin, especially in patients with COVID-19 and CKD.

 

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