Case Report of Severe Clostridium difficile Infection Presenting with Incidental Finding of Isolated Pulmonary Embolism

Abstract: Clostridium difficile infection is a leading cause of healthcare-associated diarrhea with significant morbidity and mortality, particularly in immunocompromised and elderly patients. Due to inflammation-induced hypercoagulability and depletion of anticoagulant proteins, emerging links to thromboembolic complications have been described; nevertheless, thromboembolic events are still considered rare. An elderly male patient with multiple comorbidities presented with a chronic history of diarrhea. Confirmed to have severe C. difficile colitis and an incidental finding of arterial thromboembolic event in the form of pulmonary embolism (PE) in the setting of severe hypoalbuminemia and malabsorption. The patient received targeted antibiotics, anticoagulation, and supportive management. Marked resolution of his condition was proven with clinical, laboratory, and radiological evidence. The hypercoagulable status, loss of anticoagulants, thrombin generation, endothelium dysfunction from sepsis, stasis, and advanced age are all risk factors that have resulted in our case of severe Clostridial colitis, complicated by PE. As such, patients are at higher risk of developing such complications; close monitoring should be warranted for thromboembolic events in patients with Clostridium difficile , in particular, those with severe infection.