Gram positive bacilli

Question 1

what are the basic pathological principles of Clostridium difficile (Pseudomembranous colitis)?

Answer 1

can be part of normal flora
froms subterminal endospores (dormant and highly resistant cell to preserve the cell’s genetic material in times of extreme stress)

Question 2

what causes Clostridium difficile (Pseudomembranous colitis) infections?

Answer 2

1. disturbance to microbiota in intestine
2. infection of gut produces toxins
3. toxins binds to receptors on intestine wall + are internalised
4. toxins fuse with lysosome
5. toxins exit endosome + damage cytoskeleton = cell apoptosis
6. inflammatory response = accumulation of inflammatory cells, fibrin and dead cells
7. formation of membrane like structures (psuedomembrane)

Question 3

what are the virulence factors of Clostridium difficile (Pseudomembranous colitis)?

Answer 3

enterotoxin A
cytotoxin B

Question 4

how is Clostridium difficile (Pseudomembranous colitis) infection transmitted?

Answer 4

fecal-oral route by ingestion of spores

Question 5

what are risk factors associated with infections caused by Clostridium difficile (Pseudomembranous colitis)?

Answer 5

antibiotic exposure - disturbes intestinal microbiota
previous hospitalisation - increased risk of infection
children with neutropenia - more prone to infections so require antibiotics

Question 6

what are secondary compications caused by Clostridium difficile (Pseudomembranous colitis) infection?

Answer 6

multiple relapses
dehydration
GI complications
splenic abscess + osteomyelitis

Question 7

what are the signs and symptoms of Clostridium difficile (Pseudomembranous colitis) infection?

Answer 7

• watery diarrhea with mucus/blood
• abdominal distention + cramps
• malasie
• fever

Question 8

how can you diagnose Clostridium difficile (Pseudomembranous colitis) infection?

Answer 8

colonoscopy shows plaques
increased WBC count
stool culture
presence of bllood/mucus in stool

Question 9

how can you treat Clostridium difficile (Pseudomembranous colitis) infections?

Answer 9

Medications:
* mild disease: oral metronidazole
* severe disease: oral vacomycin
* recurrent: probiotics
Surgery:
* colectomy
Other:
* electroyte + fluid replacement
* pulse therapy