Infectious

Clostridium Difficile

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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.


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