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Clostridium Difficile


Presentation

  • CONCLUSIONS: This patient presented with symptomatic Clostridium difficile at an early age causing significant morbidity and reduced quality of life.[ncbi.nlm.nih.gov]
  • The present study evaluated the in vitro bactericidal effect of cadazolid and comparator antibiotics against four C. difficile strains.[ncbi.nlm.nih.gov]
  • We present a case of a patient with ulcerative colitis and recurrent CD infection successfully treated with FT.[ncbi.nlm.nih.gov]
  • This case presentation highlights the need to consider C. difficile colitis in the differential diagnosis of severely ill patients, even in the absence of traditional risk factors or symptoms.[ncbi.nlm.nih.gov]
  • Mixed infection with more than one toxigenic isolate was present in 5/16 (31.3%) individuals.[ncbi.nlm.nih.gov]
Aspiration
  • Patients with impaired conscious states suffering from recurrent episodes of aspiration are at increased risk by endoscopic interventions needed during standard approaches for fecal microbiota transplantation application.Here, we illustrate the case of[ncbi.nlm.nih.gov]
  • There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics.[ncbi.nlm.nih.gov]
  • PubMed View Article Google Scholar Kelly CP, Pothoulakis C, Orellana J, LaMont JT: Human colonic aspirates containing immunoglobulin A antibody to Clostridium difficile toxin A inhibit toxin A-receptor binding. Gastroenterology. 1992, 102: 35-40.[doi.org]
Diarrhea
  • Surveillance Definitions C. difficile –associated diarrhea was defined by the presence of diarrhea and a positive assay for C. difficile toxin A, toxin B, or both; by the sudden onset of diarrhea with no alternative explanation and a diagnosis of pseudomembranous[doi.org]
  • In March 2003, several hospitals in Quebec, Canada, noted a marked increase in the incidence of Clostridium difficile-associated diarrhea.[ncbi.nlm.nih.gov]
  • Data showed the study reached the primary endpoint of non-inferiority to vancomycin with respect to time to resolution of diarrhea.[web.archive.org]
  • […] and have little or no diarrhea.[archpedi.jamanetwork.com]
Abdominal Pain
  • The diagnosis is easily established in the presence of purpura, but may be challenging in its absence, especially when colicky abdominal pain precedes the cutaneous lesions.[ncbi.nlm.nih.gov]
  • We present a 62-year-old African American female with a long history of HIV infection, who presented with abdominal pain and continuous diarrhea due to pseudomembranous colitis.[ncbi.nlm.nih.gov]
  • On the third day postoperatively, the patient developed left lower abdominal pain and profuse diarrhoea.[ncbi.nlm.nih.gov]
  • Clinical presentation is varied; some patients are asymptomatic, in symptomatic form the main symptom is diarrhea of varying severity, which is sometimes accompanied by acute abdominal pain, nausea, vomiting and high fever.[ncbi.nlm.nih.gov]
  • Symptoms of C. diff infection can be mild such as watery diarrhea three or more times a day with mild abdominal pain or tenderness or maybe more severe with diarrheal episodes reaching 15 times a day with severe abdominal pain , blood or pus in the stool[medicinenet.com]
Abdominal Cramps
  • Resolution of diarrhoea and abdominal cramping was noted on 6-week follow-up visit. 2014 BMJ Publishing Group Ltd.[ncbi.nlm.nih.gov]
  • This is a case of a 63-year-old, post total colectomy patient, who presented to the hospital with watery diarrhoea, abdominal cramping and fevers. On admission, the patient was haemodynamically stable and febrile.[ncbi.nlm.nih.gov]
  • Symptoms of C. difficile associated disease (CDAD) can include: diarrhea or loose stools, fever, abdominal pain and abdominal cramps. In some cases diarrhea may be mild, and the patient will improve without the need for treatment.[eportal.mountsinai.ca]
  • These include loose stools and mild abdominal cramps to profuse diarrhea and severe abdominal pain. Other symptoms include fever, nausea and vomiting and poor appetite. Diarrhea can also include blood.[gastrohealth.com]
  • Patients with mild C. difficile colitis may have: a low-grade fever , mild diarrhea (5-10 watery stools a day), mild abdominal cramps and tenderness.[medicinenet.com]
Chronic Diarrhea
  • Left unchecked, C. difficile bacteria can cause chronic diarrhea, leaving sufferers virtually confined to their bathrooms.[cbc.ca]
Pus in Stool
  • Clostridium Difficile (C. diff) Infection Digestive system Diarrhea Fever Appetite loss Nausea Abdominal pain Rapid heart rate Dehydration Blood in stool Pus in stool Weight loss Bacterial infection Exposure to contaminated surface Overview Clostridium[nm.org]
Left Ventricular Dysfunction
  • Sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction.[ncbi.nlm.nih.gov]
Altered Mental Status
  • CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage.[ncbi.nlm.nih.gov]

Workup

  • Laboratory workup revealed high white blood cell (WBC), serum creatinine (Scr), and C-reactive protein (CRP) levels. Based on these abnormal lab results, rapid detection of glutamate dehydrogenase and toxin A and B was performed.[ncbi.nlm.nih.gov]
  • (See Presentation and Workup .)[emedicine.com]
Bilateral Pulmonary Infiltrate
  • She became hypoxemic; CT scan findings showed bilateral pulmonary infiltrates. Broncho-alveolar lavage was consistent with pulmonary hemorrhage.[ncbi.nlm.nih.gov]
Colitis
  • Abstract Antibiotic-associated colitis is a gastrointestinal complication of antibiotic use commonly seen in hospitalised patients, with Clostridium difficile (C. difficile) colitis being the most common type.[ncbi.nlm.nih.gov]
  • Further clinical improvement and the resolution of colitis was observed. CONCLUSION: In this case, severe CDI colitis was successfully treated with the combination of FMT and fidaxomicin. 2016 S. Karger AG, Basel.[ncbi.nlm.nih.gov]
  • […] with C difficile colitis).[dx.doi.org]
  • KEYWORDS: Clostridium difficile colitis; signet ring cell carcinoma; signet ring cell change[ncbi.nlm.nih.gov]
  • Ipilimumab is associated with several immune-related adverse effects, of which diarrhoea and colitis are the most common.[ncbi.nlm.nih.gov]

Treatment

  • At least five patients were reported to undergo a third treatment, with resolution in three of them. Only one patient was reported to have received four treatments without long-term resolution of symptoms.[ncbi.nlm.nih.gov]
  • A course of metronidazole is the initial treatment; however up to 40% of patients have at least one recurrence. Some patients have recurrent infections requiring further treatment with vancomycin, others need multiple courses of expensive treatment.[ncbi.nlm.nih.gov]
  • In comparison with placebo, MDX- 066/MDX-1388 treatment reduced recurrence rates by approximately 70% (p 0.0004). The antibody combination treatment was generally safe and well-tolerated. Full results are expected later in 2008 or early 2009.[web.archive.org]
  • Although incidence rates continue to be low, in vitro resistance to antibiotics used for the treatment of CDI has been noted.[dx.doi.org]
  • Consequently, alternative treatments to the standard antibiotic therapies are now being considered. One alternative treatment is fecal microbiota transplant.[ncbi.nlm.nih.gov]

Prognosis

  • Leukemoid reaction is rarely seen with CDI, and indicates severe disease with grave prognosis. We present an elderly female who developed leukemoid reaction in response to CDI.[ncbi.nlm.nih.gov]
  • The prognosis of CDI patients was similar to that of CDI- patients.Hospitalized IBD patients with exacerbation treated with antacids or recently hospitalized are at increased risk for CDI and should be tested and empirically treated until confirmation[ncbi.nlm.nih.gov]
  • Regarding CDI treatment, the percentage of patients treated with metronidazole decreased (88.9% vs 52.6%) (RR 0.59 (0.48-0.73), P CONCLUSIONS: Changes in CDI management were associated with a stable prognosis (percentage of cures and first recurrences[ncbi.nlm.nih.gov]
  • […] ascites) is seen in up to 40% of cases 8 although typically the whole colon is involved, the right colon and transverse colon may be affected in isolation in up to 5% of cases 2 rectal involvement in the vast majority of cases (90-95%) 2 Treatment and prognosis[radiopaedia.org]
  • Gravel et al. [ 1 ] appropriately caution that a wrong interpretation of their results could show a worse prognosis with vanco-mycin use.[dx.doi.org]

Etiology

  • Abstract Clostridium difficile (CD) infection is currently the most frequent etiology of nosocomial diarrhea. Besides, its incidence is progressively increasing in ambulatory patients.[ncbi.nlm.nih.gov]
  • Sepsis is an exception, regardless of the etiologic pathogen, in which case an excess of catecholamines may result in acute left ventricular dysfunction.[ncbi.nlm.nih.gov]
  • Abstract Clostridium difficile is the major etiological agent of pseudomembranous colitis and is found in up to 20% of adult inpatients. The recommended treatment is antibiotic therapy with metronidazole and/or vancomycin.[ncbi.nlm.nih.gov]
  • […] immunology False Negative Reactions Female Glycosylation Humans Immunocompromised Host Immunoglobulin G/blood Multiple Trauma/complications Protein Processing, Post-Translational Protein Stability Risk Factors Toxemia/blood Toxemia/diagnosis Toxemia/etiology[ncbi.nlm.nih.gov]
  • Alternative etiologies should be sought even in those with a positive test result for C difficile . Testing in the second and third year of life is difficult to interpret; alternative etiologies should be sought.[pediatrics.aappublications.org]

Epidemiology

  • This is the first report on molecular epidemiological analyses for CDI in multiple university hospitals in Japan, to our knowledge.[ncbi.nlm.nih.gov]
  • To determine the molecular epidemiology of C. difficile in British Columbia and compare between two time points in one region. Methods.[ncbi.nlm.nih.gov]
  • BACKGROUND: Clostridium difficile infection (CDI) is a common complication of lung and allogeneic hematopoietic cell (HCT) transplant, but the epidemiology and outcomes of CDI after transplant are poorly described.[ncbi.nlm.nih.gov]
  • BACKGROUND: The epidemiological landscape of Clostridium difficile infection (CDI) has changed over the past 30 years. AIM: To review studies of CDI in the community setting.[ncbi.nlm.nih.gov]
  • Abstract Because the epidemiology of Clostridium difficile infection (CDI) is region-specific, the present study was undertaken to examine the epidemiology of C difficile outbreaks in Beijing, China.Eighty nonduplicate isolates were collected from March[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Its pathophysiology allows C difficile to be very difficult to manage, both within the hospital environment and in a patient's body.[ncbi.nlm.nih.gov]
  • Although the exact cause of this patient's neuropathy cannot be confirmed, it has been speculated that the pathophysiology is an immune-mediated process.[ncbi.nlm.nih.gov]
  • With a better understanding of the intricacies of the colonic microbiome and its role in colonic physiology and pathophysiology, critical care nurses will recognize that fecal microbiota transplant has the potential to become the standard of care for[ncbi.nlm.nih.gov]
  • Pathophysiology of CDI in Cancer Patients The diverse clinical manifestations of CDI range from asymptomatic colonization to fulminant colitis.[omicsonline.org]
  • : Types, Symptoms, and Treatments See Slideshow References Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease REFERENCE: "Clostridium difficile in adults: Epidemiology, microbiology, and pathophysiology[medicinenet.com]

Prevention

  • KEYWORDS: Clostridium difficile; Lactobacilli probiotics; Prevention [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • Author information 1 Division of Infection Control and Prevention, Osaka University Hospital, Japan.[ncbi.nlm.nih.gov]
  • Source: Centers for Disease Control and Prevention The Advice for Patients feature is a public service of JAMA Pediatrics .[archpedi.jamanetwork.com]
  • AIM: A cost-effectiveness analysis was conducted to assess the economy of probiotics for the prevention of CDAD in children and adolescents receiving antibiotics.[ncbi.nlm.nih.gov]

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