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Clostridium Infection


Presentation

  • Occasionally, patients with CDI present with unexplained leukocytosis and little evidence of gastrointestinal symptoms. Patients with severe disease may also present with an ileus rather than diarrhea.[oncologynurseadvisor.com]
  • Free abdominal air will be present in cases of bowel perforation. Abdominal computed tomography (CT) shows pronounced thickening of colonic wall in pseudomembranous colitis.[clinicaladvisor.com]
  • Clostridium difficile (C. difficile or C. diff) is a bacterium that is normally present in the body in small numbers.[gikids.org]
  • Page last reviewed: 13/07/2011 Clostridium difficile (C. difficile) are bacteria that are present naturally in the gut of around two-thirds of children and 3% of adults. C. difficile does not usually cause any problems in healthy people.[hse.ie]
Gangrene
  • Gas gangrene Can be caused by various clostridia - eg, Clostridium perfringens , Clostridium septicum , Clostridium novyi and Clostridium histolyticum . See separate Gas Gangrene article. Tetanus Caused by Clostridium tetani .[patient.info]
  • Like its cousins, the Clostridia that cause tetanus, botulism, and gas gangrene, C. diff passes through a life cycle in which the actively dividing form transforms itself into the spore stage.[health.harvard.edu]
  • A fourth patient, treated by the upper gastrointestinal route, was hospitalized for Fournier gangrene.[academic.oup.com]
Aspiration
  • In these patients the inoculum was not further diluted, to minimize risk of vomiting and aspiration.[academic.oup.com]
Sneezing
  • ., infants/young children, patients/residents/clients not capable of self care / hand hygiene, have poor compliance with respiratory hygiene, copious respiratory secretions, frequent coughing/sneezing, diarrhea, etc.); in a specific environment (e.g.,[canada.ca]
Abdominal Rigidity
  • Toxic megacolon is a clinical diagnosis based on severe systemic toxicity and radiological findings (see below) while bowel perforation presents as acute abdomen with abdominal rigidity and septic shock. B.[clinicaladvisor.com]
Metallic Taste
  • The limitations to the use of metronidazole are oral intolerance due to nausea and metallic taste and dose-dependent peripheral neurotoxicity. Hence, the use of metronidazole beyond a first recurrence is not recommended.[clinicaladvisor.com]

Workup

  • Donors Of 37 candidates who responded to our call for volunteers, 12 passed the initial screening and underwent a full donor workup.[academic.oup.com]

Treatment

  • Treatment depends on severity of the colitis. If your child has mild diarrhea caused by C. difficile, stopping any other antibiotic treatments may be sufficient therapy.[gikids.org]
  • Another study comparing treatment of CDI with vancomycin or metronidazole in patients risk-stratified by infection severity showed significantly less treatment-refractory disease after treatment with vancomycin in severe cases of CDI (32% refractory disease[f1000research.com]
  • You may need another course of treatment.[bupa.co.uk]
  • Options, agents, recommendations and algorithms for the treatment of Clostridium difficile (C. difficile) infection.[gov.uk]

Prognosis

  • Patient prognosis is clearly related to the age and underlying illnesses of the patient.[oncologynurseadvisor.com]
  • Prognosis : guarded to poor. Pathogenesis Etiology Naturally occuring bacteria Clostridium perfringens Clostridium perfringens type A has been identified as a cause of acute colitis in adult horses.[vetstream.com]
  • Prognosis and Patient Counseling. The patient should be advised about home hygiene including the importance of hand washing with soap and water, especially after using the bathroom and before food preparation.[clinicaladvisor.com]
  • What is the outlook (prognosis)? Most people with C. difficile infection recover, some even without any treatment. However, the diarrhoea can be unpleasant and, in some cases, can last for several weeks.[patient.info]

Etiology

  • CDI is defined as a case of diarrhea or toxic megacolon without other known etiology that meets 1 or more of the following criteria: the stool sample yields a positive result of a laboratory assay for C. difficile toxin A and/or B, or a toxin-producing[idph.iowa.gov]
  • The differential diagnosis should include non-infectious etiologies like postinfectious irritable bowel syndrome and osmotic diarrhea, though the latter usually resolves with fasting.[clinicaladvisor.com]
  • 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]
  • Pathogenesis Etiology Naturally occuring bacteria Clostridium perfringens Clostridium perfringens type A has been identified as a cause of acute colitis in adult horses.[vetstream.com]
  • Diarrhea etiology in a children's hospital emergency department: a prospective cohort study. Clin Infect Dis. 2006; 43 (7):807–813. [ PubMed ] 20. Boenning D.A., Fleisher G.R., Campos J.M., Hulkower C.W., Quinlan R.W.[ncbi.nlm.nih.gov]

Epidemiology

  • Wu: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, 509 Blockley Hall, Philadelphia, PA 19104. Dr.[annals.org]
  • Epidemiology C. difficile is a very robust microorganism that survives in the environment either as viable bacteria or as spores.[hps.scot.nhs.uk]
  • Cohen S.H., Gerding D.N., Johnson S., Society for Healthcare Epidemiology of America; Infectious Diseases Society of America Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology[ncbi.nlm.nih.gov]
  • CDI CDI Infection Control Today Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Updates by SHEA and IDSA Clostridium difficile-Associated Diarrhea and Colitis: Clinical Practice Guidelines by the Society for Healthcare Epidemiology[idph.iowa.gov]
  • The study reported in the journal, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC), looked at 2.2 million C. difficile infections.[foodsafetynews.com]
Sex distribution
Age distribution

Pathophysiology

  • Foals Pathophysiology Pathogenicity depends on production of enterotoxins. Clostridial infection of the small and large intestines severe damage to the bowel walls.[vetstream.com]
  • : 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

  • CDI can be prevented by: Only take antibiotics as needed and as prescribed by your health care provider.[idph.iowa.gov]
  • Prevention includes responsible antibiotic prescribing and vigilant handwashing. Probiotics prevent antibiotic-associated diarrhea, but are not recommended specifically for preventing C. difficile infection.[aafp.org]
  • Early detection of new emerging hypervirulent strains is essential to control and prevent the spread of such clones.[hps.scot.nhs.uk]
  • Prevent infections caused by bacteria. This will help prevent your need for an antibiotic. Ask about vaccines that you need. Wash your hands frequently to prevent the spread of infection.[drugs.com]

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