2016 Volume 49 Issue 8 Pages 539-546
Clostridium difficile colitis is considered to be a healthcare facility-associated infection caused by antimicrobial therapy; however, the number of community-acquired cases of C. difficile infection involving patients with no history of anti-microbial therapy has recently been growing. Herein, we report a case in which a patient with end-stage renal disease developed fulminant C. difficile colitis, which was suspected to be community-acquired, and exhibited melena and massive bleeding. As this was a community-acquired case, appropriate laboratory tests for C. difficile infection were not performed, resulting in a delayed diagnosis. Since end-stage renal disease put the patient in an immunocompromised state, he should have been considered to be at high risk of C. difficile infection despite the fact that he had no history of anti-microbial therapy. The present case suggested the importance of community-acquired C. difficile colitis in end-stage renal disease.
