Toxic Clostridioides (formerly Clostridium) difficile colitis: No longer a diarrhea associated infection
| Autor: | Emmanuel Nwachuku, Todd Braun, Yizhi Shan, Thai Vu, Prabhu Senthil-Kumar, Ryan Shadis, Orlando Kirton |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Diarrhea
Male medicine.medical_specialty Toxic megacolon Constipation medicine.drug_class medicine.medical_treatment Antibiotics Gastroenterology Clostridium Difficile Colitis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Colectomy Aged Aged 80 and over business.industry Clostridioides difficile General Medicine Middle Aged medicine.disease Colitis Clostridium Infections Defecation Surgery Female medicine.symptom business 030217 neurology & neurosurgery Clostridioides |
| Zdroj: | American journal of surgery. 221(1) |
| ISSN: | 1879-1883 |
| Popis: | Background Clostridioides difficile infection (CDI) is traditionally taught to be an antibiotic associated diarrheal infection. This diagnosis is based on the presence of clinical symptoms (usually defined as more than 3 watery, loose or unformed stool within 24 h) coupled with a diagnostic test. There is now a new presentation of CDI, including progression to toxic megacolon, in patients without diarrhea. Methods We report a case series of 9 surgical patients from a single institution who developed CDI without preceding diarrhea. Result All 9 patients had CDI with positive laboratory testing for C. difficile toxin. They, however, presented with a lack of or minimal bowel movements. Six patients had rapid development of abdominal distention, 1 patient had a single episode of watery stool in 3 days, while the other 2 patients presented with constipation. Seven patients received stool softeners, suppositories and/or enemas for presumed constipation. Four patients had a mild course of infection and were successfully treated medically. The other 5 patients developed toxic megacolon, and eventually required total abdominal colectomy. Out of the 5 patients that required total colectomy, 2 expired. Conclusion CDI must be suspected in patients who rapidly develop abdominal distention, vague abdominal complaints or change in bowel function even in the absence of diarrhea, especially if coupled with multi-system organ failure. |
| Databáze: | OpenAIRE |
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