A rare effect of a commonly used therapy or sever Clostridium difficile caused haemorrhagic colitis in association with Schönlein-Henoch vasculitis after Helicobacter pylori eradication

Scönlein-Henoch vasculitis (SHV) in pediatrics is a relatively common disease. Its main signs can be typical purpuras, abdominal pain, kidney disease, and arthritis. The average age of the patients is around five years. It is thought that in the development of SHV viral and bacterial agents has the main causative role. Beyond the most commonly accounted Streptococcuses or other respiratory tract infective agents, there are other rarer germs which could be etiologic factors.

With the presentation of our case we would like to emphasize the possible association of Clostridium difficile infection and SHV, what is lesser-known, but already written in the literature.

Our patient is a 3,5 year old boy, who got Hp. eradication therapy, because of C13 UBT positivity, which test was made for the sake of epigastrical pain. Approximately 1 week later the child was admitted to our clinic because of sharpening abdominal pain, great pieces mucosa containing bloody diarrhoea. The clostridium toxin analysis from the faeces was definitely positive. The toxin positivity in correlation with the anamnesis and the clinical signs confirmed the diagnosis of C. difficile caused colitis. On the started oral metronidazole and symptomatic therapy the patient recovered, but after 1 week we observed specific purpuras, mild proteinuria and microhematuria with arthralgia which made the diagnosis of SHV. Following the symptoms SHV healed spontaneously, and we could not detect any complication. The Clostridium associated colitis cured definitively as well.