{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:30:01Z","timestamp":1784194201918,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T00:00:00Z","timestamp":1340323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe disease caused by <jats:italic>\n<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>lostridium difficile<\/jats:italic> is frequently encountered in transplant recipients and carries a high mortality. Numerous studies have been published on this subject in the adult population, but few in the pediatric setting. A 4\u2010year\u2010old boy who had undergone heart transplant 20\u00a0months earlier was admitted to the pediatric intensive care unit after humoral rejection. Seven days after admission, he developed septic shock, abdominal distension, and paralytic ileus without diarrhea. Pseudomembranous colitis due to <jats:italic>\n<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>. difficile<\/jats:italic> was confirmed by microbiological and radiological studies. Despite treatment with rectal vancomycin and intravenous metronidazole, the patient did not improve and required decompressive laparotomy; because of the poor subsequent clinical course, terminal ileostomy and cecostomy were performed in a second operation. Recovery was satisfactory, and surgical reconstruction of intestinal tract was performed 3\u00a0months later without complications. Although early surgery with total colectomy is indicated, when there is a poor response to medical treatment in cases of <jats:italic>\n<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>. difficile<\/jats:italic> toxic megacolon, the case we present responded favorably to a conservative surgical approach that enabled intestinal integrity to be restored 3\u00a0months later. In the pediatric population, less aggressive therapeutic options should be considered, as they have benefits on the subsequent quality of life of the patient.<\/jats:p>","DOI":"10.1111\/j.1399-3062.2012.00756.x","type":"journal-article","created":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T17:32:51Z","timestamp":1340386371000},"source":"Crossref","is-referenced-by-count":8,"title":["Conservative surgical treatment for toxic megacolon due to <i><scp>C<\/scp>lostridium difficile<\/i> infection in a transplanted pediatric patient"],"prefix":"10.1111","volume":"14","author":[{"given":"A.","family":"Castillo","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Panadero","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"Pediatric Surgical Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Padilla","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Infectious Diseases Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bustinza","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Department Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2010.01397.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.04.057"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.07.040"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/593958"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2010.01314.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e3283186b51"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.1554"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1093-2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2009.04.011"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/30141083"},{"key":"e_1_2_6_12_1","first-page":"1536","article-title":"Clostridium difficile\u2010associated colitis","volume":"50","author":"Hull MW","year":"2004","journal-title":"Can Fam Physician"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2010.026"},{"issue":"4","key":"e_1_2_6_14_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00384-002-0453-0","article-title":"Current indications for blow\u2010hole colostomy: ilestomy procedure. A single center experience","volume":"18","author":"Remzi FH","year":"2003","journal-title":"Int J Colorectal Dis"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-3062.2012.00756.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-3062.2012.00756.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T12:54:46Z","timestamp":1700571286000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-3062.2012.00756.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,22]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1111\/j.1399-3062.2012.00756.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-3062.2012.00756.x","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,22]]}}}