Clinical manifestations of pseudomembranous colitis

Pathological Condition ◽

Clinical Manifestations ◽

Initial Manifestation ◽

Main Clinical Manifestation

Pseudomembranous colitis is a pathological condition in which there is damage to the mucous membrane of the large intestine with focal or diffuse fibrin depositions resulting from exposure to factors of the pathogenicity of Clostridium difficile. This disease has become quite widespread in recent years. The widespread and not always properly controlled prescription of antibiotics can lead to the development of a serious complication caused by this pathogen. The pathological condition develops against the background or after the end of the ongoing antibiotic therapy; its initial manifestation is antibiotic-associated diarrhea (AAD). Most often, this condition is diagnosed in postoperative patients against the background of a general decrease in immunity, as well as as a result of prolonged and uncontrolled intake of antibiotics. It has been proven that the frequency of Clostridium difficile colonization increases sharply during hospitalization, thus, this infection was referred to hospital ones. The main clinical manifestation of pseudomembranous colitis is diarrhea; stool can become more frequent, up to 5-7 times a day, while feces are scanty and not abundant. In addition to diarrhea, abdominal pain and flatulence may occur. The diagnosis is established on the basis of the fact of increased stool within two or more days for 8 weeks after taking antibiotics confirmed by the patient.

Managing Antibiotic Associated Diarrhea With Pseudomembranous Colitis: A Case Report

International Healthcare Research Journal ◽

10.26440/ihrj/02_02/165 ◽

2018 ◽

Vol 2 (2) ◽

pp. 35-37

Author(s):

Kandla Sharma ◽

Ankit Mangla

Keyword(s):

Helicobacter Pylori ◽

Adverse Event ◽

Case Report ◽

Clostridium Difficile ◽

Antibiotic Therapy ◽

Clostridium Difficile Infection ◽

Faecal Examination ◽

Oral Metronidazole

Antiobiotic associated diarrhea is a usual adverse event during antibiotic therapy. We present the case of a 32-year-old female diagnosed with diarrhea induced by antibiotics. After eradication of Helicobacter pylori by using antibiotics, she presented with hemorrhagic stools. The faecal examination was positive for, Clostridium difficile infection (CDI) although no toxins were detectable. Vancomycin was initiated for the C. difficile infection but the condition worsened due to treatment non-compliance. Finally oral metronidazole was prescribed. Stool abnormality improved and faecal test became negative after metronidazole treatment.

Antibiotic-associated diarrhea in children: how to identify, what to do and how to treat?

Medical Council ◽

10.21518/2079-701x-2016-1-78-89 ◽

2016 ◽

Vol 1 (1) ◽

pp. 78-89

Author(s):

I. N. Zakharova ◽

I. V. Berezhnaya ◽

E. B. Mumladze

Keyword(s):

High Risk ◽

Antibiotic Therapy ◽

Intestinal Microbiota ◽

High Probability ◽

Inflammatory Diseases ◽

Pediatric Practice ◽

New Generation ◽

Very High

Rational antibiotic therapy is one of the most important components in the treatment of children with various infectious and inflammatory diseases. However, wide and sometimes unjustified use of AB in pediatric practice often leads to the development of a variety of complications. Children receiveing AB, especially during the first 5 years of life, are at a very high risk of developing antibiotic-associated diarrhea (AAD) which manifests itself in three or more episodes of unformed stools for two or more consecutive days or for 8 weeks after withdrawal. The most relevant pathogen of AAD is C. difficile which, according to various data, causes from 10 to 25% of AAD cases and 90 to 100% of all cases of pseudomembranous colitis (PMC). Given the high probability of developing dangerous complications such as PMC, special attention should be paid to the prevention of the infection associated with C. difficile by reducing the frequency of uncontrolled and unjustified use of AB. A new generation of eco-antibiotics can be recommended which allow to maintain diversity of the intestinal microbiota and are less likely to cause complications.

Sulphasalazine-Induced Pseudomembranous Colitis

Canadian Journal of Gastroenterology ◽

10.1155/1991/420864 ◽

1991 ◽

Vol 5 (5) ◽

pp. 167-170 ◽

Cited By ~ 4

Author(s):

Hugh J Freeman ◽

Urs P Steinbrecher ◽

WC Peter Kwan ◽

Stephanie Ensworth

Keyword(s):

Inflammatory Bowel Disease ◽

Abdominal Pain ◽

Ankylosing Spondylitis ◽

Clostridium Difficile ◽

Bowel Disease ◽

Flexible Sigmoidoscopy ◽

Frequent Use ◽

Toxin Assay ◽

Inflammatory Bowel

An 18-year-old female with ankylosing spondylitis developed fever, abdominal pain and diarrhea on two occasions after starting sulphasalazine therapy. Flexible sigmoidoscopy revealed pseudomembranous colitis; fecal cultures were positive forClostridium difficile; andC difficiletoxin assay was positive. Despite the frequent use of sulphasalazine in the management of inflammatory bowel disease, this complication has been apparently rare. Clinicians should be wary of the onset of diarrhea in patients receiving sulphasalazine, whether for inflammatory bowel disease or other conditions.

Role of Clostridium difficile Toxins in Antibiotic-Associated Diarrhea and Pseudomembranous Colitis

Microbial Toxins ◽

10.1007/978-94-007-6725-6_17-1 ◽

2016 ◽

pp. 1-18 ◽

Cited By ~ 1

Author(s):

Diana López-Ureña ◽

Carlos Quesada-Gómez ◽

César Rodríguez ◽

Esteban Chaves-Olarte

Keyword(s):

Clostridium Difficile ◽

Antibiotic Associated Diarrhea

Pseudomembranous colitis during antibiotic therapy

Medicinski pregled ◽

10.2298/mpns0308381c ◽

2003 ◽

Vol 56 (7-8) ◽

pp. 381-383 ◽

Cited By ~ 1

Author(s):

Predrag Canovic ◽

Zoran Todorovic ◽

Olgica Gajovic ◽

Ljiljana Nesic ◽

Zeljko Mijailovic

Keyword(s):

Clostridium Difficile ◽

Antibiotic Therapy ◽

Biopsy Specimen ◽

Clinical Course ◽

Neutralization Test ◽

Antibiotic Use ◽

Normal Flora ◽

First Case ◽

Benign Process

Introduction The use of antibiotics is commonly accompanied by diarrhea: idiopathic diarrhea with a benign process and diarrhea caused by Clostridium difficile and pseudomembranous colitis. Clostridium difficile colonizes the gastrointestinal tract and produces a toxin in cases when normal flora is suppressed by antibiotics. Pseudomembranous colitis most frequently appears after application of clindamycin, lincomycin, ampicillin, cephalosporins and other antibiotics. Diagnosis is established after rectoscopic findings of adherent pseudomembrane and pathohistological verification. The diagnosis is confirmed if there is evidence of Cl. difficile toxin in feces. Case report We report about the clinical course of two patients with antibiotic-associated colitis. The diagnoses were made by clinical examinations, rectoscopy and pathohistologic verification of biopsy specimen of the intestinal mucosa. Neutralization test was not done due to technical reasons. Patients were treated with metronidazole. Unwanted side-effects of metronidazole therapy were not observed. Discussion Both our patients confirmed that they previously used different antibiotics. In the first case, diarrhea appeared during the antibiotic therapy, and in the second case, after finishing it. After antibiotic use, diarrhea appears in 5.30% cases, but fortunately pseudomembranous colitis is rare. However, taking into consideration that pseudomembranous colitis has a severe course and requires urgent treatment, one has to consider the possibility of pseudomembranous colitis when diarrhea appears during and after antibiotic use in order to initiate adequate therapy.

Antibiotic-associated diarrhea in hospital: frequency and prophylaxis

Medical alphabet ◽

10.33667/2078-5631-2021-20-35-37 ◽

2021 ◽

pp. 35-37

Author(s):

Yu. P. Uspenskiy ◽

N. V. Baryshnikova

Keyword(s):

Intensive Care ◽

Clostridium Difficile ◽

Antibiotic Therapy ◽

Clinical Manifestation ◽

Hospital Setting ◽

Toxin A ◽

Stool Analysis ◽

B Test ◽

Gastrointestinal Microflora

The aim. To analyze the prevalence of antibiotic-associated diarrhea (AAD) caused by Clostridium difficile in a hospital setting.Materials and methods. 93 patients with 3 or more episodes of unformed stool (diarrhea) for two consecutive days or more, developed after the use of antibiotics, were monitored. All patients underwent rapid stool analysis for the presence of Clostridium difficile A and B toxins using the X/pert C. diff toxin A/B test.Results. Toxins A and/or B of Clostridium difficile were detected in 32 patients (34.4 %). The remaining patients (n = 61; 65.6 %) had idiopathic AAD. The most of the patients who were found to have Clostridium difficile toxins in the feces were in the infarction department, cardiology intensive care and trauma departments, i. e. they had severe diseases associated with reduced immunity and inactivity.Conclusions. The prevalence of AAD caused by Clostridium difficile in hospital settings is high. It is recommended to prescribe drugs for the correction of disorders of the gastrointestinal microflora from the first day of antibiotic therapy, since this will significantly reduce the prevalence of clinical manifestation of diarrhea associated with Clostridium difficile.

PREVALENCE OF CLOSTRIDIUM DIFFICILE INFECTION IN PATIENTS EXPOSED TO ANTIBIOTICS IN PREVIOUS 6 WEEKS AND ADMITTED WITH DIARRHEA IN A TERTIARY CARE HOSPITAL.

10.36106/ijsr/0713671 ◽

2021 ◽

pp. 62-64

Author(s):

Sanjay Kumar Singh ◽

Ashwini Kumar Setya ◽

Abhishek Deo ◽

Vivek Raj ◽

Suneel Chakravarty

Keyword(s):

Clostridium Difficile ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Manifestations ◽

Diagnostic Methods ◽

Care Hospital ◽

Common Cause ◽

Wide Range ◽

Antibiotic Associated Diarrhoea

Clostridium difficile is a signicant cause of morbidity and mortality among hospitalized patients, and the incidence of C. difficile infection (CDI) has dramatically increased due to frequent usage of broadspectrum antibiotics in these patients. The wide variation in the spectrum of clinical manifestations of CDI makes the diagnosis difcult. Further, the wide range of variability in the sensitivity and specicity of the various diagnostic methods and the high cost of these methods add to the difculty. It is a spore-forming gram-positive anaerobic organism. Until the 1970s, it was considered as a microorganism that is rarely present in normal intestinal microbiota. But it was not until 1978 that C. difcile was identied as a cause of [1] pseudomembranous colitis . Since then, C. difcile has been recognized as a common cause of antibiotic associated diarrhoea and nosocomial diarrhoea. The incidence of C. difcile infection (CDI) varies from place to place. In India, it is known to infect up to 25 % of [2] people taking antibiotics