Clostridium Difficile (C. diff) Infection

Question 1

How is it transmitted?

What does it usually come after and why?

Answer 1

Spores from people or the environment

The course of antibiotics as it eliminates gut flora so allows C.diff to proliferate.

Question 2

How does it present? - 3

One complication that could lead to surgery?

Answer 2

Profuse watery D
Abdominal pain and tenderness
Fever

Toxic megacolon

Question 3

Investigations:

Why do you do FBC?

What would indicate severe C.diff which you would find from U&E’s?

What should also be done to the stool?

Answer 3

Raised WBC

AKI - severe C. diff

PCR +/- toxin immunoassay to confirm

Question 4

Management:

What should be stopped if they are on them?

What medications are given?

Answer 4

Stop ABs

Vancomycin PO
Fidaxomicin PO
Metronidazole PO - first line in europe