Fulminant Clostridium difficile infection with toxic megacolon.
C. difficile infection is a common cause of infectious diarrhea, especially in presence of risk factors such as older age (>65 years), hospitalization or nursing home stay, antibiotic use and immunocompromised states. The 2-step algorithm used to make a diagnosis is shown in Figure 1. Classification of severity of infection is performed based on the features outlined in Figure 2. For severe fulminant infection a combination of oral and rectal vancomycin, parenternal metronidazole and fecal microbiota transplantation is recommended.
Two-Step Diagnostic Algorithm (Figure 1):
Classification of Disease Severity (Figure 2):
Case authored by: Shabari Shenoy MD, Jiyoon Yoon MD, and Bhavana Bhagya Rao MD
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