Clostridial Infection

Question 1

Clostridial Infection Microbiology

Answer 1

• Anaerobic, gram positive, spore-forming rods

- Form resistant spores under stress can produce powerful exotoxins

Question 2

PMC Definition

Answer 2

• Acute, exudative colitis

- Can rarely be caused by other bacteria

Question 3

C. Difficile Presentation

Answer 3

• Can be asymptomatic carrier
• Mild diarrhoea
• Pseudomembranous Colitis
• Or fulminant colitis
• Generally Hx of antibiotic exposure with RFs for colonisation
• 5-10 days after colonisation
• Frank rectal bleeding suggest other cause, occult bleeding can occur

Question 4

C. Difficile Differentials

Answer 4

• Crohn’s
• UC
• Diverticular disease

Question 5

C. Difficile Ix

Answer 5

• Bloods
• Stool sample
• Only test diarrhoeal stool
• AXR and CT useful in severe disease (e.g. severe distension)
• Thumbprinting seen later
• Must report positive case detected in any form (e.g. finding PMC on colonoscopy)

Question 6

C. Difficile Management

Answer 6

• Metronidazole or vancomycin
• Avoid antiperistaltics due to risk of retention of toxins
• Cease causative antibiotics