Flashcards
Clostridium Difficile Infection
Cards in this deck (11)
- 1What are risk factors for C. Diff infection?- Recent antibiotic use
- Older age (>65 years)
- Gastric acid suppression
- Female gender
- Certain underlying medical conditions e.g. IBD, cancer, kidney disease, diabetes
- Recent hospitalisation
- Previous GI surgery - 2What are potential complications of C. Diff infection?Toxic megacolon
Pseudomembranous colitis
Perforation - 3What is toxic megacolon?- Acute toxic colitis accompanied by dilatation of the colon
- Involves non-obstructive dilatation >6cm and signs of systemic toxicity - 4What are signs of systemic toxicity seen in toxic megacolon?- Fever
- Tachycardia
- Leukocytosis
- Dehydration
- Altered mental state
- Electrolyte derangement
- Hypotension - 5What would you suspect in someone with colonic dilatation but no signs of systemic toxicity?Not toxic megacolon. May be Hirschsprung disease or pseudo obstruction.
- 6How can you treat toxic megacolon?- Reduce colon distension to prevent perforation
- Correct any fluid/electrolyte disturbances
-Treat precipitating factors (e.g. C. Diff infection) - 7Define pseudomembranous colitis- Defined by the presence of 'pseudomembranes' on the mucosa of the colon or the small intestine.
- Pseudomembranes = layer of acute inflammatory cells, caused by C. Diff toxin release causing mucosal inflammation and damage - 8What is defined as severe C. Diff infection?Patient has severe C. Diff infection if they have one or more severity markers present:
○ WBC >15
○ SCr >1.5 baseline
○ Suspicion of/confirmed pseudomembranous colitis, toxic megacolon or ileus
○ Evidence of severe colitis on AXR or CT
○ Temperature >38.5 - 9How should C. Diff infection be managed?Antibiotics - oral metronidazole if no severity markers, oral vancomycin if severe CDI.
IV fluids
Analgesia
VTE prophylaxis
Correct electrolyte abnormalities
Stop drugs such as PPIs, causative Abx, diuretics - 10What Abx are higher risk for development of CDI?- Clindamycin
- Co-amoxiclav
- Ceftriaxone (cephalosporin)
- Ciprofloxacin - 11What type of bacteria is C. Diff?Anaerobic, gram +ve bacilli
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- Infectious Diseases Flashcards on Clostridium Difficile Infection, created by Jenna Paterson on 20/10/2020.
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- Jenna Paterson
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