Abstract
Prolonged unexplained fever is a continuing problem in chronic renal failure patients on hemodialysis (HD) and poses a diagnostic problem. These patients have an increase in susceptibility to various infections, caused by usual pathogens, as well as by opportunistic organisms.
We report a 10-year-old patient with chronic renal failure on HD, who developed prolonged unexplained fever secondary to pseudomembranous colitis associated with clostridium difficile toxin in the stools. She was admitted for HD and treated with tobramycin and cefazolin for fever, pneumonia and atelectasis of left lung for 3 weeks. Fever recurred 3 weeks after antibiotic therapy (AT) and persisted for 6 more weeks. She also developed bloody diarrhea 4 weeks after AT. Blood, stool, urine and sputum cultures for virus, fungus, and bacteria were negative. Stool, however, was positive for clostridium difficile toxin (CDT) (>1:1000). She became afebrile 2 days after oral vancomycin therapy (VT). Diarrhea and fever recurred when VT was discontinued but normalized after restarting VT therapy. Clostridium difficile infection should be considered in prolonged unexplained fever in HD patients.
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Agrawal, R., John, E., Assadi, F. et al. 1048 FEVER IN A HEMODIALYSIS PATIENT. Pediatr Res 19, 285 (1985). https://doi.org/10.1203/00006450-198504000-01078
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DOI: https://doi.org/10.1203/00006450-198504000-01078
