PSEUDOMEMBRANOUS COLLITIS;
~up to 50% mortality
~antibiotic associated
~diagnose by finding Clostridium difficile toxins in stool
~20% ascending colon only
~treatment: METRONIDAZOLE/VANCOMYCIN
Relapse occurs up to 20% and treated with oral vancomycin
1)state of hydration 2)volume depleted(even
in young) with tachycardia and postural
hypertension. 3)infective cause, may present
in severe collitis .4) abdominal examinations
5)sigmoidoscopy and rectal biopsy
Annotations:
Abdominial examinations may reveal non-specific tenderness.
Sig and rectal b mayb useful but does not distinguis btwn various cases
SIGNS OF CHRONIC:
1)clubbing, 2)koilonychia
3)leukonychia 4)mouth ulcers
5)weight loss
investigations
a) blood test: 1)FBC; anaemia or thrombocytosis suspect its chronic.
Low albumin tells severity but non-specific. 2)stool culture presence of
toxin c.difficile 3) plain abdominal x-ray(show acute collitis
Annotations:
C. difficile bacteria are found 5% in normal individual. diagnosis therefore requires appropriate SYMPTOMS rather than the organisms alone!
Management
1)rehydration- resting the gut and rehydrate
2)treat underlying cause: antibiotics or steroids
is used with known pathogen