The following are the most important diseases or complications that may be contributed to by pseudomembranous enterocolitis (Clostridium difficile-associated diarrhea or Clostridium difficile infection, CDI):
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Dehydration (lack of fluids).
- Hypalbuminemia (too low a concentration of albumin in the blood).
Infectious and parasitic diseases (A00-B99).
- Recurrence (recurrence) of pseudomembranous colitis.
- After initial infection: approximately 20% of patients.
- After first relapse: 40-65%.
- Sepsis (blood poisoning)
Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).
- Enteral protein loss syndrome (abnormally increased protein loss by passage from the blood through the intestinal mucosa into the intestinal lumen).
- Ileus (intestinal obstruction)
- Colonic perforation – rupture of the colon wall (intestinal perforation).
- Irritable bowel syndrome (IBS) – functional bowel disorder in which no causative disorders can be found; IBS in the sense of postinfectious IBS.
- Toxic megacolon – toxin-induced paralysis and massive dilatation of the colon (widening of the large intestine; > 6 cm), which is accompanied by acute abdomen (most severe abdominal pain), vomiting, clinical signs of shock and sepsis (blood poisoning); lethality (mortality related to the total number of people suffering from the disease) is about 30%.
Further
- Admission to an intensive care unit
- CDI-associated death
- Colectomy – surgical removal of the entire colon (large intestine), without removal of the rectum (rectum).
Prognostic factors
- Age ≥ 80 years (odds ratio, OR 2.2).
- Heart rate > 90/min (OR 2.1)
- Tachypnea > 20/min. (OR 1.7)
- Leukopenia < 4000/µl (OR 2.6)
- Leukocytosis > 20,000/µl (OR 2.2)
- CRP ≥ 150 mg/l (OR 3.6)
- Hypalbuminemia < 25 g/l (OR 3.1)
- Urea > 7 (OR 3.0) or > 11 mmol/l (OR 4.9).
Other prognostic factors include:
- Fever > 38.5 °C
- Lactate elevation ≥ 5 mmol/l
- Creatinine increase > 50
- Significant comorbidities Concomitant diseases (e.g., renal failure/renal impairment, immunosuppression).
