Spontaneous excretion of a pseudomembranous intestinal cast in an infant with an acute diarrhoeal illness: A case report and literature review

We present a case of an 8-week-old infant with acute bloody diarrhoea and subsequent passage of an intestinal cast. An extensive immune and infection work-up did not reveal a causative aetiology. Histopathology indicated the cast represented an intestinal pseudomembrane. 16S bacterial polymersae chain reaction of the pathology specimen was negative. The infant required a period of parenteral nutrition due to diarrhoeal losses but made a full recovery and had no sequelae from this illness. Intestinal casts are a rare occurrence, particularly in paediatrics. It prompts a wide differential which includes acute infection, immunodeficiency and ischaemia. Accurate quantification of stool losses, appropriate nutrition support and liaison with microbiology colleagues were essential in this case.