Leukemoid reaction due to Clostridium dificile infection in acquired immunodeficiency syndrome: two case reports and a review of the literature.

Publisher: Southern Medical Association Country of Publication: United States NLM ID: 0404522 Publication Model: Print Cited Medium: Print ISSN: 0038-4348 (Print) Linking ISSN: 00384348 NLM ISO Abbreviation: South Med J Subsets: MEDLINE

Original Publication: Birmingham, AL : Southern Medical Association

Clostridioides difficile* ; Immunocompromised Host*; AIDS-Related Opportunistic Infections/*immunology ; Acquired Immunodeficiency Syndrome/*immunology ; Enterocolitis, Pseudomembranous/*immunology ; Leukemoid Reaction/*microbiology; Adult ; Fatal Outcome ; Female ; Humans ; Male ; Middle Aged

The clinical presentation of colitis associated with Clostridium difficile infection in immunosuppressed patients with acquired immunodeficiency syndrome (AIDS) has not been completely characterized. Previous reports suggest that these patients present with low blood leukocyte counts, consistent with the impaired myelopoiesis that can occur with human immunodeficiency virus (HIV) infection. In contrast, we describe the cases of two patients with colitis associated with C difficile infection who developed intense leukemoid reactions despite being in advanced stages of AIDS. To the best of our knowledge, these are the first described cases of leukemoid reaction associated with C difficile or other bacterial infection in AIDS patients. We review the literature on C difficile colitis in patients infected with HIV and suggest that severe C difficile infection should be considered in such patients presenting with leukemoid reaction and diarrhea.

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Date Created: 20040428 Date Completed: 20040519 Latest Revision: 20201208

20231215

10.1097/01.smj.0000051279.00946.2c

15108834