Clostridium Difficile

Question 1

Is Clostridium Difficile gram positive or gram negative?

Answer 1

Gram positive rod

Question 2

Describe the pathophysiology of the damage it causes to the gut?

Answer 2

It produces an exotoxin that causes intestinal damage leading to pseudomembranous colitis.

Question 3

What is the antibiotic that is most associated with causing C. Diff?

Answer 3

2nd and 3rd generation cephalosporins

Question 4

What other antibiotic was, in the past, the leading cause of C. Diff?

Answer 4

Clindamycin.

Question 5

What are the features of C. Diff?

Answer 5

• Diarrhoea
• Abdominal pain
• A raised white blood cell count is characteristic
• If severe toxic megacolon may develop

Question 6

How do you diagnose C Diff?

Answer 6

Clostridium difficile toxin in the stool

Question 7

What is the management of C. Diff?

Answer 7

• First line - 10-14 days of Metronidazole
• Second line - Oral Vancomycin.
• Life threatening - oral Vancomycin + Metronidazole.

NOTE: Needs to be oral not IV - oral gets to the gut better.

Question 8

What is this a sign of?

Answer 8

Thumb printing - seen in colitis.