Infectious colitis Flashcards
What kind of bacteria is C.diff
anaerobic gram positive, spore-forming, toxin producing bacillus
How is C.diff transmitted
faecal-oral route by ingestion of spores
How does C.diff result in colitis
releases 2 exotoxins -
Toxin A and Toxin B
act on intestinal epithelial cells and inflammatory cells resulting in colitis
What are risk factors for getting C.diff
antibiotics such as -
co-amoxiclav, cephalosporins,ciprofloxacin, clindamycin
PPI
What may someone with infectious colitis present with
profuse watery diarrhoea
colicky abdominal pain
What makes infectious colitis mild on severity scale
Normal WCC
What makes IC moderate on severity scale
raised WCC <15
3-5 loose stools a day
What makes IC severe on severity scale
raised WCC > 15 or an acutely raised creatinine >50% above baseline
or temp >38.5
or evidence of severe colitis - ( abdominal or radiological signs )
What makes IC life threatening on severity scale
hypotension
partial/complete ileus
Toxic megacolon or CT evidence of severe disease
What is stepwise investigations for suspected IC
- arrange bloods- raised WCC
2.arrange stool testing
3.obtain imaging - AXR
- can consider colonoscopy/flexi
What is the gold standard investigation
stool culture - to detect CDT in the stool
What is the stepwise management for C.diff
- infection control – patient isolated
2.Medication review- stop all causative agents
3.Antibiotic
- consider surgery
How you treat first episode of C.diff infection
first line - ORAL VANCOMYCIN 10 days
second line- oral FIDAXOMICIN
third line - Oral vancomycin/metronidazole
How do you treat recurrent episodes of C.diff
within 12 weeks - oral FIDAXOMICIN
after 12 weeks - oral vancomycin/fidaxomicin
How do you treat life threatening C.diff infection
oral vancomycin and IV metronidazole
specialist advice
