pseudomembranous_colitis
pseudomembranous colitis
Introduction
Aetiology
Risk factors
any antibiotic can cause it, but especially broad spectrum beta lactams (penicillins, cephalosporins) or clindamycin
elderly
hospitalisation
presence of a virulent strain in the hospital
poor hand hygiene (spores are spread from faeces to surfaces to hands of healthcare workers)
inadequate cleaning of hospital rooms on discharge of patient
past GIT surgery
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renal impairment
prolonged elemental diet (lacking in protein)
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Clinical features
usually present with
diarrhoea which is usually profuse, watery/mucoid and foul smelling (horse manure smell), and may contain blood or pseudomembranes
may then develop:
Diagnosis
suspect if new onset of more than three partially formed or watery stools per 24-hour period whilst on, or had recent antibiotics, especially if in hospital, and especially if develops abdominal pain and fever
urgent stool C.Diff PCR
Mx
supportive care
IV rehydration may be required
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look for markers of severe disease:
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or oral qid
vancomycin with cholestyramine (binds the two toxins) may be used in severe cases
+/- faecal / stool transplant
patients with severe disease will require iv antibiotic Rx and may require ICU care
pseudomembranous_colitis.txt · Last modified: 2018/08/11 14:13 (external edit)