C Diff infection

Question 1

Pathogenesis

Elaborates toxins

Process of toxins

Toxins interfere w

Resulting damage to

Answer 1

Spore forming, toxin producing gram pos anaerobe

a and b- cell destruction/activate IS

enter cell via endocytosis, induce change in cell structure

mito membrane- apop, cell destxn

tight jxn, fluid sec

Question 2

Associated w

contact w

Answer 2

recent AB use

healthcare institutions

Question 3

CM

diarrhea is usually

severe, fulminant dz

may progress to

identified by

toxic bc

Answer 3

water diarrhea, ab pain, low fever

large volume, very frequent

high fever, severe pain/distension/diarrhea

Toxic megacolon- progressive dilation

ab rigidity/guarding/dim bowel sounds/RT

systemic toxicity and colonic perforation

Question 4

Dx scenario

Testing

Furter

Answer 4

pt w 3+ watery stools per day over 2 days + RF (inc immunosuppresion)

C diff toxin assay/PCR

Colonoscopy- psuedomembrane colitis (not specific)- ischemic mucosal injury

Question 5

Biopsy appearance

if toxic megacolon/severe colitis found get

Answer 5

PMNs in superficial LP w distended/damaged crypts (volcano/mushroom)

X ray/CT

Question 6

Mx

Institute

confirmed infection, tx w

Answer 6

stop AB/antimotility agents (leads to TM)

infection control- soap and water

vancomycon or metro orally

Question 7

Complications

Answer 7

recurrence 1-3 wks later