Clostridium difficile

Question 1

What is Clostridium difficile?

Answer 1

Clostridium difficile (CDI) is a gram positive bacteria that causes pseudomembranous colitis, commonly seen in patients who have recently been on a course of broad spectrum antibiotics.

Question 2

What is pseudomembranous colitis caused by?

Answer 2

C. difficile

Question 3

What are risk factors for developing C. difficile infection?

Answer 3

Have been treated with broad-spectrum antibiotics

Have had to stay in a healthcare setting, such as a hospital or care home, for a long time

Being over 65

Have certain underlying conditions, including inflammatory bowel disease (IBD), cancer, or kidney disease

Taking a PPI

Question 4

What are the clinical features of a C. difficile infection?

Answer 4

Watery diarrhoea, which can be bloody
Painful abdominal cramps
Nausea
Signs of dehydration, such as dry mucous membranes, tachycardia and oliguria
Fever
Loss of appetite and weight loss
Confusion

Question 5

How would you manage C. difficile?

Answer 5

First line is Vancomycin 125mg PO QDS

Second line is Fidamomicin 200mg PO BD

Question 6

What are the complications of C. difficile?

Answer 6

Pseudomembranous colitis

Colonic distension, a condition known as toxic megacolon.

Systemic toxicity and manifestations of the systemic inflammatory response syndrome