Pseudomembranous Colitis (6 of 11)

As soon as pseudomembranous colitis is suspected, the implicated antibacterial should be withdrawn, symptomatic treatment of diarrhea started and specific antibacterial therapy initiated. The diagnosis can be confirmed by the isolation of C. difficile or its toxins in stool. Infection with C. difficile is associated with a spectrum of clinical scenarios, which include an asymptomatic carrier state, simple antibiotic-associated diarrhea, pseudomembranous colitis, and fulminant colitis. The virulence of the bacteria combined with the immune status of the patient likely accounts for this variability. The majority of patients have a mild form of the disorder. New risk factors for CDC in the community such as gastric acid -suppressive agents are being identified as well as epidemiological factors leading to spread of the spores in the hospital setting. Other risk factors have been identified such as renal failure, chronic obstructive pulmonary disease, intensive care units, preoperative bowel preparations, advanced age, and altered intestinal motility. Elderly patients tend to develop infection through nosocomial spread.17 Up to 20 per cent of infected individuals develop symptomatic relapse.