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Background: Clostridium difficile infection (CDI) is characterized by diarrheal illness with serious complications. Previous literature has not reported concurrent infections of Norovirus and Clostridium difficile (C. difficile) leading to severe acidosis.
Methods: Here, we report a case of C. difficile in a 55-day-old Chinese infant with severe acidosis.
Results: We present a unique case of a patient with an initial Norovirus-positive test who received appropriate treatment but showed a poor response. Five days later, the patient tested positive for C. difficile toxins A and B. Treatment with oral vancomycin resulted in an excellent response. The patient improved clinically and remained afebrile, with cessation of diarrhea and correction of acidosis.
Conclusions: This article reports a rare case of C. difficile infection in an infant presenting with persistent diarrhea and severe metabolic acidosis, which was initially diagnosed as Norovirus, despite the absence of obvious immune deficiency. This case emphasizes the importance of considering C. difficile infection in the differential diagnosis of unexplained diarrhea when routine tests are inconclusive.
DOI: 10.7754/Clin.Lab.2025.250719
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