{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:12:12Z","timestamp":1791292332979,"version":"4.1.0"},"reference-count":13,"publisher":"SMC Media","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>The development of Clostridium difficile infection in COVID-19 patients is an understudied complication of the disease. Herein, we present the case of a 46-year-old man who developed severe healthcare-associated C. difficile infection leading to toxic megacolon and perforation in the setting of COVID-19 infection. It is important to continue to follow guidelines regarding antibiotics in healthcare settings to prevent such complications.<\/jats:p>","DOI":"10.12890\/2021_002771","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T03:20:25Z","timestamp":1629775225000},"source":"Crossref","is-referenced-by-count":6,"title":["COVID-19 and Fulminant Clostridium difficile Colitis Co-Infection"],"prefix":"10.12890","volume":"8","author":[{"given":"Abdul Ahad Ehsan","family":"Sheikh","sequence":"additional","affiliation":[{"name":"The Wright Center for Graduate Medical Education, Department of Internal Medicine, Scranton, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu Baker","family":"Sheikh","sequence":"additional","affiliation":[{"name":"University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishan","family":"Shah","sequence":"additional","affiliation":[{"name":"University of New Mexico Health Sciences Center, Department of Internal Medicine, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Hamza","family":"Khair","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nismat","family":"Javed","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Shekhar","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, University of New Mexico School of Medicine, Department of Internal Medicine, Albuquerque, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"10.12890\/2021_002771_ref1","doi-asserted-by":"crossref","unstructured":"<li>Khanna S, Kraft CS. The interplay of SARS-CoV-2 and Clostridioides difficile infection. <em>Future Microbiol<\/em> 2021;<strong>16<\/strong>:439\u2013443. <\/li>","DOI":"10.2217\/fmb-2020-0275"},{"key":"10.12890\/2021_002771_ref2","doi-asserted-by":"crossref","unstructured":"<li>Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, et al. Coronavirus disease 2019 case surveillance - United States, January 22\u2013May 30, 2020. <em>MMWR Morb Mortal Wkly Rep<\/em> 2020;<strong>69<\/strong>:759\u2013765. <\/li>","DOI":"10.15585\/mmwr.mm6924e2"},{"key":"10.12890\/2021_002771_ref3","doi-asserted-by":"crossref","unstructured":"<li>Tirlapur N, Puthucheary ZA, Cooper JA, Sanders J, Coen PG, Moonesinghe SR, et al. Diarrhoea in the critically ill is common, associated with poor outcome, and rarely due to <em>Clostridium difficile<\/em>. <em>Sci Rep<\/em> 2016;<strong>6<\/strong>:24691. <\/li>","DOI":"10.1038\/srep24691"},{"key":"10.12890\/2021_002771_ref4","doi-asserted-by":"crossref","unstructured":"<li>Bentivegna E, Alessio G, Spuntarelli V, Luciani M, Santino I, Simmaco M, et al. Impact of COVID-19 prevention measures on risk of health care-associated <em>Clostridium difficile<\/em> infection. <em>Am J Infect Control<\/em> 2021;<strong>49<\/strong>:640\u2013642. <\/li>","DOI":"10.1016\/j.ajic.2020.09.010"},{"key":"10.12890\/2021_002771_ref5","doi-asserted-by":"crossref","unstructured":"<li>Rawson TM, Moore LSP, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. Bacterial and fungal coinfection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. <em>Clin Infect Dis<\/em> 2020;<strong>71<\/strong>:2459\u20132468. <\/li>","DOI":"10.1093\/cid\/ciaa530"},{"key":"10.12890\/2021_002771_ref6","doi-asserted-by":"crossref","unstructured":"<li>Zuo T, Zhang F, Lui GCY, Yeoh YK, Li AYL, Zhan H, et al. Alterations in gut microbiota of patients with COVID-19 during time of hospitalization. <em>Gastroenterology<\/em> 2020;<strong>159<\/strong>:944-955.e8. <\/li>","DOI":"10.1053\/j.gastro.2020.05.048"},{"key":"10.12890\/2021_002771_ref7","doi-asserted-by":"crossref","unstructured":"<li>Huttner BD, Catho G, Pano-Pardo JR, Pulcini C, Schouten J. COVID-19: don't neglect antimicrobial stewardship principles! <em>Clin Microbiol Infect<\/em> 2020;<strong>26<\/strong>:808-810.<\/li>","DOI":"10.1016\/j.cmi.2020.04.024"},{"key":"10.12890\/2021_002771_ref8","doi-asserted-by":"crossref","unstructured":"<li>Granata G, Bartoloni A, Codeluppi M, Contadini I, Cristini F, Fantoni M, et al. The burden of Clostridioides difficile Infection during the COVID-19 pandemic: a retrospective case-control study in italian hospitals (CloVid). <em>J Clin Med<\/em> 2020;<strong>9<\/strong>:3855. <\/li>","DOI":"10.3390\/jcm9123855"},{"key":"10.12890\/2021_002771_ref9","doi-asserted-by":"crossref","unstructured":"<li>Guh AY, Mu Y, Winston LG, Johnston H, Olson D, Farley MM, et al. Burden of Clostridioides difficile infection and outcomes. <em>N Engl J Med<\/em> 2020;<strong>382<\/strong>:1320-1330. <\/li>","DOI":"10.1056\/NEJMoa1910215"},{"key":"10.12890\/2021_002771_ref10","doi-asserted-by":"crossref","unstructured":"<li>Ramalingam S, Gunasekaran K, Arora H, Muruganandam M, Padmanabhan P. <em>Clostridium difficile<\/em> and noncirrhotic hyperammonnemia in a patient with COVID-19 infection. <em>Cureus<\/em> 2021;<strong>13<\/strong>:e14533. <\/li>","DOI":"10.7759\/cureus.14533"},{"key":"10.12890\/2021_002771_ref11","doi-asserted-by":"crossref","unstructured":"<li>Rokkam VRP, Kutti Sridharan G, Vegunta R, Vegunta R, Boregowda U, Mohan BP. <em>Clostridium difficile<\/em> and COVID-19: novel risk factors for acute portal vein thrombosis. <em>Case Rep Vasc Med<\/em> 2021;<strong>2021<\/strong>:8832638. <\/li>","DOI":"10.1155\/2021\/8832638"},{"key":"10.12890\/2021_002771_ref12","doi-asserted-by":"crossref","unstructured":"<li>P\u00e1ramo-Zunzunegui J, Ortega-Fern\u00e1ndez I, Calvo-Espino P, Diego-Hern\u00e1ndez C, Ariza-Ibarra I, Otazu-Canals L, et al. Severe <em>Clostridium difficile<\/em> colitis as potential late complication associated with COVID-19. <em>Ann R Coll Surg Engl<\/em> 2020;102:e176-e179. <\/li>","DOI":"10.1308\/rcsann.2020.0166"},{"key":"10.12890\/2021_002771_ref13","doi-asserted-by":"crossref","unstructured":"<li>Sandhu A, Tillotson G, Polistico J, Salimnia H, Cranis M, Moshos J, et al. Clostridioides difficile in COVID-19 Patients, Detroit, Michigan, USA, March-April 2020. <em>Emerg Infect Dis<\/em> 2020;<strong>26<\/strong>:2272\u20132274.<\/li>","DOI":"10.3201\/eid2609.202126"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2771\/2807","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2771\/2808","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/2771\/2808","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T13:33:42Z","timestamp":1756128822000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/2771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.12890\/2021_002771","relation":{"has-manifestation":[{"id-type":"other","id":"1-74-2771-g2807","asserted-by":"subject"},{"id-type":"other","id":"1-74-2771-g2808","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-74","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]},"article-number":"10"}}