Diagnosis and treatment of Clostridium difficile colitis

Article Abstract:

Pseudomembranous colitis that occurs following antibiotic treatment is an inflammation of the large intestine (colon) caused by toxins produced by the bacterium Clostridium difficile. The bacterium is sometimes found in healthy people, but its growth is inhibited by the other bacteria that normally reside in the intestines. Antibiotic treatment alters this balance by killing the normal bacteria, allowing Clostridium difficile to multiply. The toxins attack the lining of the intestine, causing diarrhea, abdominal pain, fever and dehydration. It is usually diagnosed by endoscopy, but the bacterium can also be isolated from stool samples with rapid and inexpensive tests. Treatment includes discontinuing the offending antibiotics and giving patients replacement fluids. Vancomycin and metronidazole can be used to eradicate the bacterium. Lactobacillus or Saccharomyces (a yeast) can be given to patients on antibiotics to prevent pseudomembranous colitis.

Care and treatment, Antibiotics, Complications and side effects, Enterocolitis, Pseudomembranous, Antibiotic-associated colitis, Enterocolitis, Necrotizing enterocolitis

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Does this patient have community-acquired pneumonia?

Article Abstract:

It may be difficult to diagnose community-acquired pneumonia based on the physical examination alone. The physical exam relies mostly on listening to the lungs through a stethoscope and examining the chest for any asymmetries while the patient breathes. The most common findings are a dullness when the chest is tapped, abnormal sounds during inspiration and expiration and crackles on inspiration. Other symptoms include cough, shortness of breath, and chest pain. No combination of exam findings can clinch the diagnosis, which may require a chest X-ray.

Evaluation, Medical examination, Pneumonia, Patients, Physical diagnosis

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Derivation and Validation of Guidelines for Stool Cultures for Enteropathogenic Bacteria Other Than Clostridium difficile in Hospitalized Adults

Article Abstract:

Hospitals that perform all stool culture analysis within three days of admission may miss patients who have a gastrointestinal infection. Researchers who extended the three-day rule identified 52 patients who would not have been detected. About half of these patients required antibiotic treatment.

Analysis, Feces, Gastrointestinal diseases

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