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Clostridium Difficile Infection

 Syn. CDI , Clostridium difficile-associated disease

Signs & Symptoms

 Hospitalization
Ref: Uptodate [ Clostridium difficile infection in adults: Epidemiology, microbiology, and pathophysiology]
History of sever illness
Ref: Uptodate [ Clostridium difficile infection in adults: Epidemiology, microbiology, and pathophysiology]
Watery diarrhea
Note: ≥3 loose stools in 24 hours
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis] Harrison [ 965] Epocrates [ https://trello.com/c/YbJpiCWx/101-clostridioides-difficile-associated-disease]
Antibiotics
Note: Most case occur within two weeks of antibiotic therapy
Ref: Uptodate [ Clostridium difficile infection in adults: Epidemiology, microbiology, and pathophysiology] Harrison [ 964] Epocrates [ https://trello.com/c/YbJpiCWx/101-clostridioides-difficile-associated-disease]

Physical Examination

 Lower abdominal tenderness
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis] Epocrates [ Https://online.epocrates.com/diseases/230/Clostridioides-difficile-associated-disease]
Localized tenderness in the left lower quadrant
Note: due to Megacolon
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]
Localized tenderness in the right lower quadrant
Note: due to Megacolon
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]

Lab / Serology

 Leukocytosis
Note: Average Wbc=15000
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis] Harrison [ 965] Epocrates [ Https://online.epocrates.com/diseases/230/Clostridioides-difficile-associated-disease]
Detection of toxin B in stools
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]
Positive laboratory stool test for C. difficile toxin
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]

Imagin Study

 Accordion sign
Note: due to pseudomembranous colitis
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]
Bowel wall edema
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]
Bowel wall erythema
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]

Complication

 Sepsis
Ref: Harrison [ 965]
Lactic acidosis #Severe_CDI
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]
Hypoalbuminemia
Note: note to Serum albumin levels below 2.0 g/dL ,due to Protein-losing enteropathy
Ref: Uptodate [ Clostridium difficile infection in adults: Clinical manifestations and diagnosis]

Risk Factors

 Elder
Ref: Uptodate [ Clostridium difficile infection in adults: Epidemiology, microbiology, and pathophysiology]
Obesity
Ref: Uptodate [ Clostridium difficile infection in adults: Epidemiology, microbiology, and pathophysiology]

Cause

Other