Ruby’s C. diff story started when she was 4 years-old and she took amoxicillin for an ear infection. A few days after starting amoxicillin, she developed a secondary low grade fever and extreme diarrhea. We (her parents) took her to the pediatrician and convinced them to test her for C. diff, which they reluctantly agreed to. We knew that this was not simply an upset stomach from the antibiotic. To the pediatrician’s surprise, she tested positive for the C. diff antigen and toxin. She was put on Flagyl for 10 days and her symptoms resolved.

When she was 6 years-old, she again got put on an antibiotic (Cefdinir), which the provider suggested would not increase the likelihood of a C. diff recurrence. This time, her symptoms were more subtle. She developed intermittent diarrhea during the first week on the antibiotic, but it would clear up for a few days and then restart again. This perplexing pattern persisted for months and included intermittent diarrhea, constant susceptibility to upper respiratory infections, low grade fevers, and many missed days of school. Due to the presentation of symptoms, the doctors did not want to test for C. diff.

After a few months of back and forth trips to various doctors and pediatricians without any viable explanations, Ruby developed hives and severe joint pain. We promptly brought her to the emergency room where they ran many different tests. At the ER visit, the only test that came back abnormal was her CBC. While we waited for other test results to trickle in over the next few days, we asked for a C. diff panel to be completed again. When all the test results were finally completed, the only positive test was for C. diff (antigen and toxin).

We were referred to a pediatric infectious disease doctor and she was put on 10 days of vancomycin followed by a vancomycin pulse-taper. Within a week of stopping the pulse-taper of cancomycin, Ruby developed diarrhea, hives, and acute arthritis again. She was promptly put on 10 days of Dificid. Her symptoms cleared up within a week. She has been off Dificid for a while now and is symptom free. We do not know how she originally acquired the C. diff infection, but we suspect it was during a visit from her great grandmother that came directly from an assisted living facility.

While Ruby remains symptom free, the mental and emotional toll that C. diff had on the family was immense. We are hopeful that she will have a normal life but we do not believe this will be her last battle with C. diff. Every loose stool, slight rash, or complaint about a joint sends us back into a dark place that we never want to revisit. We are sharing this story to highlight the importance of early testing, even when symptoms do not present in the typical C. diff fashion. Children are very resilient, but this resilience can sometimes mask a serious illness, such as C. diff, resulting in a delayed diagnosis that could have lifetime consequences.