Afro-Egypt J Infect Endem Dis 2011 Dec ;1(2):A6

 

Clostridium Difficile Colitis

 

Hunter S

 

Cairo University, Egypt

 

                              

 

ABSTRACT

Clostridium difficile is a gram positive anaerobic spore forming bacteria. It secretes 2 potent exotoxins ; enterotoxin A and cytotoxin B .It is called antibiotic associated diarrhea. The risk factors for C .difficile infection are antibiotic intake in the last 2 months , old age and hospitalization. Antibiotics as cephalosporins, penicillin, clindamycin , macrolides lead to disturbance of gut flora and colonization by C. difficile. The clinical spectrum ranges from asymptomatic , self limited diarrhea up to fulminant bloody diarrhea with perforation of the colon . Laboratory investigations revealed leucocytosis , RBCS in stool and positive C. difficile toxin by ELISA in stool .Yellow pseudo- membrane of the mucosa of the colon could be seen by endoscopy .The disease has 25% mortality rate in elderly patients. Treatment is by discontinuation of antibiotics, administration of metronidazol orally or by intravenous route and oral only vancomycine . Nitazoxanide , probiotics and cholestyramine could be used.