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Pathology
C. difficile is a gram positive anaerobe able to colonise the gut. Symptoms are produced via two toxins: A (enterotoxin) and B (cytotoxin).
Aetiology
More common with antibiotics, old age, hospital stay, institutionalisation
Signs
Abdominal tenderness, dehydration
Symptoms
Diarrhoea, abdominal pain, fever
Investigations
Bloods: FBC
Microbiology: Stool culture tested for toxins and antigen
Treatment
Prevent further infection: Isolation, barrier nursing
Medical: Fluids and stool chart. Discontinue previous antibiotics and start
metronidazole if mild to moderate, or oral vancomycin if severe or
recurrent infection.
Prognosis
Usually very good if treated quickly; recurrence rate 20%
Pseudomembranous colitis, sepsis, toxic megacolon.
Key Facts
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Key Images
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Key References
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