Chapter 26: Surgical Infections- Pseudomembranous Colitis

Question 1

What is it?

Answer 1

Antibiotic-induced colonic overgrowth of C. difficile

Question 2

What are the signs/symptoms?

Answer 2

• Diarrhea (bloody in 10% of patients)
• ± fever
• ± increased WBCs
• ± abdominal cramps
• ± abdominal distention

Question 3

What causes the diarrhea?

Answer 3

Exotoxin released by C. difficile

Question 4

How is the diagnosis made?

Answer 4

Assay stool for exotoxin titer

Question 5

What is the treatment?

Answer 5

• PO metronidazole (Flagyl®; 93% sensitive) or PO vancomycin (97% sensitive);
• discontinuation of causative agent
• Never give antiperistaltics