C Difficile + Pseudomembranous Colitis

Question 1

Definition

Answer 1

Gram +ve spore forming bacilli = Strict anaerobe

Question 2

Where is C. diff usually found

Answer 2

Normal gut flora of large intestines

Question 3

How can C.diff spread

Answer 3

Faeco-oral route
Person-person contact

Question 4

Which antibiotics are associated with C. diff

Answer 4

Clindamycin
Co-amoxiclav
Ciprofloxacin
Cephalosporins
* IV greater risk than oral *

Question 5

What is pseudomembranous colitis

Answer 5

Normal gut flora replaced by C.diff
Yellow plaques which can be easily dislodged
results in dangerous severe diarrhoea (VERY WATERY = SEVERE DEHYDRATION)
Highly infectious

Question 6

Signs and symptoms

Answer 6

Usually occurs 5-10 days after antibiotic use
- Diarrhoea +/- blood
- Abdominal discomfort/pain
- Nausea + vomiting (RARE)
- SEPSIS (RARE)

Question 7

Diagnosis

Answer 7

Stool sample for enterotoxins
= SENSITIVE + SPECIFIC

Question 8

Treatment

Answer 8

Stop Abx
FIRST LINE = METRONIDAZOLE
VACNOMYCIN = SECOND LINE
* According to NICE = Vancomycin is FL *