Clostridioides difficile Bacteremia in an Elderly Female Patient After Colon Cancer Surgery

Zhulan Yang,1 Kun Wang,2 Yi Liu,3 Xiaohong Xiang,4 Zhen Zhang2 1Department of Clinical Laboratory, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China; 2Department of Clinical Laboratory, Chongqing General Hospital, Chongqing University, Chongqing, People’s Republic of China; 3Department of Critical Care Medicine, Chongqing General Hospital, Chongqing University, Chongqing, People’s Republic of China; 4School of Pharmacy, Chongqing Medical and Pharmaceutical College, Chongqing, People’s Republic of ChinaCorrespondence: Zhen Zhang, Email [email protected] Xiaohong Xiang, Email [email protected]: Clostridioides difficile infection (CDI) is a major healthcare-associated concern, particularly in the elderly. While CDI typically manifests as toxin-mediated colitis, hematogenous dissemination leading to bacteremia is relatively rare and associated with high mortality. We report an unusual case of C. difficile bacteremia in an octogenarian female patient occurring shortly after right hemicolectomy for ascending colon adenocarcinoma. This critically ill patient presented with bloodstream infection in the ICU following surgery. Multiple risk factors converged, including advanced age, extensive colorectal surgery with mucosal disruption, malignancy, and broad-spectrum antibiotic exposure. Blood culture identification required specific anaerobic processing. Combined intravenous and high-dose oral vancomycin therapy, guided by rapid microbiological confirmation, led to successful resolution of the bacteremia. This case underscores the potential for life-threatening C. difficile bacteremia in vulnerable elderly patients post-colorectal cancer surgery, highlights the diagnostic challenges (necessitating anaerobic blood cultures), and emphasizes the critical importance of early suspicion, aggressive multimodal therapy, and meticulous antimicrobial stewardship in this high-risk population. It serves as a crucial reminder of this devastating complication.Keywords: Clostridioides difficile, bacteremia, colon cancer