Clostridium Difficile (C Diff)

[newmum35]

Does anyone know if there is any chance of my 16 month old son knocking out a C. Diff infection on his own, WITHOUT flagyl or vancomycin?

He just came off antibiotics (augmentin) less than 24 hrs ago and his SEVERE WATERY DIARRHEA is supposed to get better within the next day or two. (He has had 3 days of it so far, but the first day it was originally loose, but within one day turned watery, and is now clear!!) I am highly suspecting this is actually a C. Diff. infection (I have had one about 1.5 years ago when I was pregnant with him!!) and not merely a bad side effect from the augmentin (of course, thats what triggered it!)

I am unsure whether to bring him in TOMORROW and insist on a stool culture (to confirm C. Diff) and thus, begin therapy right away - because C. Diff can be potentially life-threatening and can get worse quickly!!

Or to wait until friday when the dr will see him next and give him a few days to perhaps get better on his own ... if he gets worse and worse tomorrow, then obviously my question is answered and he probably has C. Diff, I will bring him right away. But if he stays the same or improves slightly? I just want to avoid another disaster (another round of antibiotics) unless its absolutely necessary.

HAS anyone fought a moderate or severe C. Diff infection on their own (and won) without flagyl or vancomycin??

According to this page (under "symptoms") he could be considered having a "severe" infection (because of the # of watery diarrhea per day, and because of loss of appetite (although he's still nursing very good):

http://www.mayoclinic.com/health/c-difficile/DS00736

He now has a bad rash around his bum from the diarrhea, which is painful for him, I can hardly touch it with a wipe.

Anyone have experience with Clostridium Difficile either in yourself or in your child?? Please share your experience!! I may need to make a decision SOON (within a day or two) about his treatment, if it turns out he does have C. Diff

Of course Im hoping that he will get better and his diarrhea will improve tomorrow - I just am not sure if this is possible with a "severe" C. Diff infection - the page says it is possible with a "mild" infection, to recover from C. Diff. after stopping antibiotics.

Anyone recover from C. Diff without using a round of antibiotics?? (flagyl/vancomycin) - also any info on which one to use in a 16 month old would be appreciated!

[koru]

No one in my household has ever had c. diff but I would take him in simply because of the amount of diarrhea. I'd be worried about dehydration...with a 16 month old, things can go downhill fairly quickly.

Are you giving your DS probiotics? I would definitely do that to restore the normal gut flora but it may be too late if the c.diff is already overgrown & the diarrhea is severe. It'll probably take both abx & probiotics to get him back into balance.

[newmum35]

The diarrhea is severe, and I am worried it might be too late and overgrown as you mention. I did start florastor with him last night. I talked to the ped. last evening, and again this morning on the phone (he had another 4 severe almost-clear watery diarrhea since last night) - since it hasn't yet been 24 hrs since he's been off the antibiotics, she thinks he may be ok since he is a healthy breast-fed baby, and would like to give him a few more days before doing a stool culture, because then he will need to be on antibiotics for C. Diff (assuming it turns up positive), and would like to avoid that if possible. I agreed to that (being that he is fairly happy and playing, and is still nursing well and drinking water) but I admit I am quite worried that he can't kick this on his own, and the damage from C. Diff to his intestine might be worse in 2 or 3 days. I am monitoring him closely of course. Also worried about possible electrolyte disturbance in 2 more days (from diarrhea) but he is nursing well and often.. If diarrhea worsens today I may bring him in sooner (tonight or tomorrow) instead of waiting til friday. I just hate to start the C. Diff antibiotic unless necessary, but I'm afraid that might be his only option I just don't know how realistic it is to expect he might recover on his own in a few days if it IS C. Diff (which I am feeling strongly that it IS C. Diff)

[momofmine]

If he is happy and playing and nursing well, it sounds like you have good advice form your doc. I would wait, but I would be doing other things. S boulardii and other probiotics, absolutely no grains, sugar, limit fruit, etc for myself and the baby. Search for posts by WuWei on probiotics.

[sbgrace]

Does it have the c. diff odor? If so I would culture. If he were hospitalized at this point he'd be in isolation while you waited on culture. If you don't have the odor I would possibly assume it is something else. We've had very severe watery diarrhea without having c. diff. They did culture in the hospital and also after a month at home when things continued. No c. diff but it was an overgrowth of something else. It did not go away with heavy probiotics/ without treatment.

But if you've got c. diff odor I personally would culture and try to wipe it out with vancomycin, florastor and culturelle or VSL#3. I would, though, think the florastor might knock it back enough not to pick up on it in culture and may even control symptoms. If you're ok with it being controlled I think it's worth a try. But if he's already colonized I don't think you'll actually wipe it out with probiotics. And I don't know if you'll get rid of symptoms either. Maybe. My son was doing heavy doses of culturelle and florastor and I still couldn't get things under control for him and it wasn't even c. diff.

You may know this but you can take florastor with the antibiotics. Antibiotics don't kill it. I always have florastor in the house just in case after our emergency hospital experience that led to our own mess.

[newmum35]

Originally Posted by sbgrace

Does it have the c. diff odor? If so I would culture. If he were hospitalized at this point he'd be in isolation while you waited on culture. If you don't have the odor I would possibly assume it is something else. We've had very severe watery diarrhea without having c. diff. They did culture in the hospital and also after a month at home when things continued. No c. diff but it was an overgrowth of something else. It did not go away with heavy probiotics/ without treatment.

But if you've got c. diff odor I personally would culture and try to wipe it out with vancomycin, florastor and culturelle or VSL#3. I would, though, think the florastor might knock it back enough not to pick up on it in culture and may even control symptoms. If you're ok with it being controlled I think it's worth a try. But if he's already colonized I don't think you'll actually wipe it out with probiotics. And I don't know if you'll get rid of symptoms either. Maybe. My son was doing heavy doses of culturelle and florastor and I still couldn't get things under control for him and it wasn't even c. diff.

You know, I did think it curious that it does not have the c diff odor. I thought this was probably cause he was primarily breastfeeding. But I do recall a horrid odor with my own C Diff. When they cultured yours, what did it end up being? Because I know you can get some false negatives when they culture, so they will reculture several times (or they should) if one turns up negative. When this happened to you, did it have the odor, and what overgrowth was it?

I have florastor and sustenex and started him on both those already. I need to get culturelle or some kind of bifidum, will try to look today. If it does not clear up by friday or the weekend, she said they will be testing him - I'm just a little worried in the meantime, about electrolyte imbalances, and the seriousness of C. Diff (that it can progress from mild to severe very fast - you are supposed to get help asap if you know you have it)

He did have an appetite for a little container of applesauce, and a 1/2 jar of sweet potatoes, and some yogurt. (in addition to breastmilk today)

You mentioned about isolation - are you kidding me - how old was your child? Did this really happen to you? Mine is 16 months, there is no way I am leaving his side for anything at the hospital, I am not sure if that is even legal for them to try to make me do that, no matter what his infection. That is crazy. I had C. Dif in the hospital 1.5 years ago while I was pregnant, and my husband was right there in the room with me for several days until I was discharged, they never asked him to leave.

[newmum35]

Can someone please point me to some links on why vancomycin would be the better choice for him (instead of flagyl) IF it ends up being Clostridium Difficile? I would like to print out some stuff and request it over the flagyl if in fact it really is better for toddlers.

[Krabs]

My FIL got C.Diff last year and was very sick. He ended up in the hospital for a week and was unable to work for a month. If it was me I would take it seriously, especially because you're saying your son was sick recently with something.

[newmum35]

update:

5 major diarrhea in last 8 hrs and guess what!!! 5th one at 3:30 pm: no more clear or pale water!!! It was pale yellow, very liquidy, softer, more watery than cottage cheese, but definitely not water!! Something there is changing- I think there might be hope he can beat this (whatever it is) before the stool culture in a few days. (or.. there may be no need for one, if he is getting significantly better by then!) I had given him contents of one capsule florastor (saccharomyces boulardii) and one sustenex (bacillus coagulans) earlier today when he ate applesauce, sweet potatoes, and some yogurt!! He's been nursing often, as usual, too. (Haven't yet found lactobacillus or bifidum, but may have them within the next day or so) I am somewhat relieved, already! My first glimmer of hope!! (He is still playing and happy, with no indications of dehydration. He is drinking water, and nursing good- not acting sickly.)

[momtoalexsarah]

Take him in, please! The solids in the poop are likey from the food you fed him. My DD was acting normal but she was already in hospital and hooked up to IV because of another infection. Isolation means that you will have to glove and gown to leave the room (you don't have to in the room) they will give you a private room and you are expected to stay there except to get food (or go to the washroom if there is not one with the room). If you need to go get food from that cafeteria then you will have to see if you can arrage for a nurse to mind you child (I just went when she was sleeping, and told them she was not to be touched unless it was an emergency). You could also have your spouse or fiend come and be with you child for a little bit but they will have to follow the biosecurity rules.
It is better to know and get it treated. The vancomcyn is normaly a second line drug for C-diff but it has less side effects especially in children. There is also less chances of finding c-diff that is resistant to vanco then Flagyl, this I think would be especially true as you had flagyl to treat yours. If you are still a carrier then the bacteria you carry may be resistant to the flagyl because it wasn't enough to kill them.
Really the vanco wasn't that bad, it's given every 6 hours with or without food and does not kill floristor so you can continue with that.
How big is your son, my DD was 23lb when we left the hospital and we did 2 capsuals a day so I would go with a full dose of it.
Good luck, I know how scary it is, but as I said quik treatment is most effective, before any lasting digestive damage is done.

[sbgrace]

You mentioned about isolation - are you kidding me - how old was your child? Did this really happen to you? Mine is 16 months, there is no way I am leaving his side for anything at the hospital, I am not sure if that is even legal for them to try to make me do that, no matter what his infection. That is crazy. I had C. Dif in the hospital 1.5 years ago while I was pregnant, and my husband was right there in the room with me for several days until I was discharged, they never asked him to leave.

No, I'm not kidding but I think the picture in your mind was different than reality. He was hospitalized and on IV antibiotics. He got green watery stools with a horrific odor (filled up the room) though not the barn type c. diff smell exactly. So they suspected C. diff and put his room in isolation. He couldn't leave the room and they had to gown and glove up when they entered. Honestly? I was nearly positive he didn't have c. diff and I figured in isolation he had less chance of getting that or anything else! It was ok. But if a person is hospitalized and they have c. diff their room is isolation. You would be able to be with him. But don't skip to that...very unlikely!

I don't remember what the specific overgrowth was but it was bacterial (hence the horrible odor). We did several c. diff cultures, all negative.

Re the vanc vs. flagyl. You just have a better chance of getting it gone the first time with the vancomycin. Flagyl has a higher rate of failure. But they do usually use it first.

If it isn't c. diff and the probiotics don't get it you can treat with gentler/more natural things and likely get rid of it. We used P73 oregano oil along with florastor and culturelle.

[tayndrewsmama]

Originally Posted by newmum35

update:

5 major diarrhea in last 8 hrs and guess what!!! 5th one at 3:30 pm: no more clear or pale water!!! It was pale yellow, very liquidy, softer, more watery than cottage cheese, but definitely not water!! Something there is changing- I think there might be hope he can beat this (whatever it is) before the stool culture in a few days. (or.. there may be no need for one, if he is getting significantly better by then!) I had given him contents of one capsule florastor (saccharomyces boulardii) and one sustenex (bacillus coagulans) earlier today when he ate applesauce, sweet potatoes, and some yogurt!! He's been nursing often, as usual, too. (Haven't yet found lactobacillus or bifidum, but may have them within the next day or so) I am somewhat relieved, already! My first glimmer of hope!! (He is still playing and happy, with no indications of dehydration. He is drinking water, and nursing good- not acting sickly.)

Not to burst your bubble, but as mentioned before, this may just be the food passing through. C. diff is nothing to mess around with. I was very, very sick with it for awhile and it was pretty scary really.

Since the symptoms point to it, the best thing to do is get a stool culture. Technically, you shouldn't even have to bring him in. If you really don't want to, call and explain the situation and tell them you want to pick up a stool kit first. The longer it goes on the worse it will be to fight it.

[MommytoTwo]

My dad got C.Diff in the rehab/nursing home after a stroke and he was very very sick for months and months and lost 65 pounds. If I knew/thought my child had it I would probably even go to the ER. After I saw what my dad went thorough it would scare the (*#@ out of me.

[Sarah W]

If I thought my child had C. Diff, I'd take them immediately to the ER. There's no way I'd wait and try anything else. It's just so severe.

My grandmother had C Diff and it was horrible. It almost killed her. It's tougher on infants and the elderly, but regular adults can get it and it can be difficult to shake. She had surgery and had been moved to a nursing home for rehabilitation. Rehab from the surgery was nothing, once she got rid of the C. Diff.

Re: Flagyl...They start out with Flagyl because it is a lot less expensive. If it doesn't work, they move on. Flagyl didn't work with my grandmother.

[momtoalexsarah]

Originally Posted by newmum35

Can someone please point me to some links on why vancomycin would be the better choice for him (instead of flagyl) IF it ends up being Clostridium Difficile? I would like to print out some stuff and request it over the flagyl if in fact it really is better for toddlers.

I asked the pead why they where using oral vanco for Megan because she had been given it IV for several days prior and my understanding was that it didn't affect the GI track. She said I was right - in IV it can't get to the GI track just as when given Oral it can't get to the blood. The really nice thing is that there is no systemic side effects like flagyl. (I had flagyl for a uterine infection after DD1 was born and it messsed up my finger and toe nails (i still have fungul toe issues because of it)
My understanding is that it is understood that Vanco is first line for infants and toddlers - just tell them that you want Vanco not Flagyl, they will tell you it costs more, just bite the bullet. As I said find a compounding pharmacy at the hospital they will make you a batch, although you may need to wait an hour or so for them to do it.
With all the horror stories I've heard my DD's case was easily handled, we had a follow up test last week and haven't got the results back yet but the she has had no diarerha in almost a month now so it is looking good. We will be following a specific protocal if she ever gets and infection or needs surgury that requires antibiotics again to gaurd against the c-diff.

[newmum35]

He is about 30 lbs... no more bowel movements since 3:30 pm mentioned previously (8 hrs ago!) I was getting relieved, I thought he was getting over it naturally but now I'm getting worried all over again after reading your latest posts.. As mentioned, I am doing what the ped recommended, and waiting 2 or 3 days - if it does not resolve by weekend, she said they will test him. (Still, I questioned whether this was the best course of action, thus, my posts!) I am so confused now what to do.

My pediatrician wasn't particularly worried about him even though I mentioned I had C Diff before, and she knew this was a possibility? There is NO odor to his stools - not the horrid odor I had when I had C. Diff. Does it produce odor in breastfed toddlers too? I told her I was worried he might have C. Diff. She wasn't that worried, I don't know why! She said he was a breastfed baby, healthy, and would be fine. I think she wanted to give him a few days because otherwise he will need to be on antibiotics again for the infection.

I am getting scared again. What if I bring him to ER and he's on another round of antibiotics all for nothing! What if I don't, and she's wrONG! The diarrhea has not continued for the past 8 hours - so , should I be as worried now? He did pee fine a few hours ago, and is nursing often, although hasn't had much appetite for anything else today. He played at the playground today with lots of energy, which I think wore him out, cause he's kind of tired, clingy and cranky tonight even though he had a few naps.

I am going to see what time, and what consistency the next bowel movement is. I have been writing them down. He hasn't had one for so long now! I touched his abdomen gently and he didn't cry so I don't think its overly tender. His rash seems to be getting better somewhat.

[WuWei]

Mama, if you could post to one thread, so that folks had 'the rest of the story', it'd help them not to scare you to death with partial information.

Your child was given antibiotics. 25-40% of everyone who takes antibiotics gets "antibiotic associated diarrhea". It ceases within about 72 hours after stopping the antibiotics. There are probiotics which help recolonize the gut. You are giving them. Yogurt has lactobacillis also. There is bifidum in your breastmilk.

Breathe. Plenty of folks take antibiotics and get diarrhea and it resolves. And you are replacing the "good bacteria" in multiple ways. Sleep, mama. It will be ok. It is scary when our children are ill, I understand. But, the risk of C. diff developing now, is quite small. You stopped the antibiotic. He is a healthy little guy. He is breastfed, hydrated, playing with a lot of energy. Your panic doesn't help him, or you. Breathe.

He is healing from the antibiotics which are harsh on a child's gut.


Pat

[mommyofatoz]

battery is about to die, but I wanted to say that my breastfed baby did get the odor with c.diff...

[sbgrace]

Ok. I went back to look at your other posts now too.
You are thinking worst case and I really think it's not c. diff. You'd have odor and worse symptoms. Indeed diarrhea is really common in antibiotic usage without probiotics. And most of those are not c. diff. I understand your concern given your own experience and what you're reading here.
But usually people who aren't hospitalized are not picking up c. diff after a round of antibiotics..particularly breastfed babies who are (via breastmilk) getting some good bacteria. Relax and continue probiotics. I think he'll be fine. If the stools continue you can culture.

[mommyofatoz]

Before we found out that my ds had c.diff, there was a smell. He also screamed during feeding (cause his belly hurt). He started to lose weight. My milk started to decrease. It was a nightmare. I it did take a while to find out what it was. I had a lot of help form the people at TBW, in fact I believe the whole thing is there somewhere, though this was back in 2006/07. They thought maybe it was allergies and I should have his stool tested. This was not even something the dr. had mentioned trying. So I requested it and that is how c.diff was discovered. He had never seen c.diff in a child, so requested another test be done for it, and sure enough...positive again. It took three rounds of antibiotics to get rid of it, and during the third time is when I started the florastor. I believe the probiotics combined with the antibiotics is what finally kicked it. Unfortunately, my milk took a huge hit and I don't think even domperidone helped me that much, but it did a little. I had to supplement with formula. I was able to nurse him until a year, though, and I felt that was a great accomplishment considering our circumstances.

So, I would say, w/out the smell, I wouldn't think of it being c.diff, but if you are worried, I would get the test...like others have said, it could just be runny stools from the antibiotics he was on...