Clostridioides difficile infection after extracorporeal membrane oxygenation support for acute myocardial infarction: a case report

Yanan Hu; Chang Hu; Jun Jiang; Jing Zhang; Yiming Li; Zhiyong Peng

doi:10.3389/fmed.2023.1333209

Clostridioides difficile infection after extracorporeal membrane oxygenation support for acute myocardial infarction: a case report

Front Med (Lausanne). 2023 Dec 22:10:1333209. doi: 10.3389/fmed.2023.1333209. eCollection 2023.

Authors

Yanan Hu^#^{1

2}, Chang Hu^#^{1

2}, Jun Jiang^{1

2}, Jing Zhang^{1

2}, Yiming Li^{1

2}, Zhiyong Peng^{1

2

3}

Affiliations

¹ Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
² Clinical Research Center of Hubei Critical Care Medicine, Wuhan, Hubei, China.
³ Center of Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.

^# Contributed equally.

Abstract

Introduction: Restored cardiopulmonary function is efficiently achieved by utilizing extracorporeal membrane oxygenation (ECMO). Nevertheless, the incidence of Clostridioides difficile infection (CDI) associated with ECMO is relatively uncommon.

Case presentation: In this report, we present the case of a 59-year-old male with severe chest pain due to acute myocardial infarction, subsequently necessitating ECMO support. During the first day of hospitalization, pulmonary infections were observed, and piperacillin-tazobactam was prescribed for 7 days at low dosages. However, the patient developed severe diarrhea 4 days later. After ruling out common pathogens, we suspected the occurrence of CDI and performed genetic testing for C. difficile toxin, confirming our diagnosis. The prescription of vancomycin resulted in slight improvement, while fecal microbiota transplantation (FMT) proved to be more effective.

Conclusion: In this case, temporary application of ECMO was applied, and the anti-infective treatment relied on the use of antibiotics at short-term, low-dose, and low CDI risk. Hence, the occurrence of CDI was considered an uncommon event, which may serve as a reference for future cases.

Keywords: Clostridioides difficile; Clostridioides difficile infection; case report; extracorporeal membrane oxygenation; fecal microbiota transplantation.

Publication types

Case Reports

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China (ZP, No. 81971816 and 82272208) and the Subject Cultivation Project of Zhongnan Hospital of Wuhan University (ZP, No. ZNXKPY2021001).