A person harboring Clostridium difficile may develop extraintestinal infections. Many of the infections require transit of the organisms via the bloodstream. Isolation of the organism requires anaerobic cultures.
Sites of extraintestinal infection associated with C. difficile:
(1) bacteremia
(2) osteomyelitis
(3) periprosthetic joint infection
(4) visceral abscess
(5) peritonitis
(6) empyema
(7) pyelonephritis
(8) skin (cellulitis) or soft tissue infection
Risk factors for extraintestinal infection:
(1) C. difficile enterocolitis in an immunocompromised patient (cirrhosis, transplantation, malignant lymphoma, immunosuppressive therapy)
(2) bowel wall penetration by surgery, trauma or rupture
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