Pseudomembranous Enterocolitis

Pseudomembranous Enterocolitis: Surgical Therapy

Surgical therapy may be necessary for complicated, fulminant C. difficile infection (CDI): Intestinal perforation – rupture of the colon wall (intestinal perforation). Severe therapy-refractory courses, especially with ileus (intestinal obstruction) or toxic megacolon – massive dilation (expansion) or enlargement of the colon in the context of inflammation. Early surgery can reduce the lethality (mortality related … Pseudomembranous Enterocolitis: Surgical Therapy

Pseudomembranous Enterocolitis: Prevention

Prevention, general Hygiene measures Restrictive use of antibiotics Preventive measures in case of illness Isolation of the patient (de-isolation can be done after 48 h without diarrhea, if necessary). Wearing gloves; protective gowns for patient contact; in addition to hand disinfection, washing hands with soap, as alcohol-based disinfectants do not have sufficient effect against spores

Pseudomembranous Enterocolitis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate pseudomembranous enterocolitis (Clostridium difficile-associated diarrhea or Clostridium difficile infection, CDI): Abrupt onset with watery foul-smelling diarrhea (> 10 bowel movements/day; duration: > 3 days). Rarely, hemorrhagic diarrhea (bloody diarrhea) occurs. Cramping abdominal pain (abdominal discomfort; pain in the lower abdomen). Fever (subfebrile temperatures) Leukocytosis (increase in the number … Pseudomembranous Enterocolitis: Symptoms, Complaints, Signs

Pseudomembranous Enterocolitis: Causes

Pathogenesis (disease development) Clostridium difficile is an obligate anaerobic gram-positive rod bacterium. By forming spores, it has a high tolerance to many chemical and mechanical stimuli. Ribotypes 014 and 020 usually result in a milder infection. Ribotypes 027, 017 (toxin-producing), and 078 (toxin-producing) can lead to severe disease. Clostridium difficile can produce the following two … Pseudomembranous Enterocolitis: Causes

Pseudomembranous Enterocolitis: Complications

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. … Pseudomembranous Enterocolitis: Complications

Pseudomembranous Enterocolitis: Classification

Clostridium difficile infection is present when one or more factors are present: Diarrhea and C. difficile toxin detection/cultural C. difficile detection in stool. Toxic megacolon (massive dilatation of the colon) and C. difficile toxin detection/cultural C. difficile detection in the stool Endoscopic detection of pseudomembranous colitis. Histopathological evidence (endoscopy, colectomy, autopsy). Severe Clostridium difficile infection … Pseudomembranous Enterocolitis: Classification

Pseudomembranous Enterocolitis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? … Pseudomembranous Enterocolitis: Examination

Pseudomembranous Enterocolitis: Test and Diagnosis

Microbiologic testing should be performed in the following situations: Symptoms consistent with Clostridium difficile infection (CDI), In persons who have been treated with antibiotics in the past 60 days. In persons who have risk factors Any diarrhea (diarrhea) lasting more than 3 days and no other known pathogen. Laboratory parameters 1st order – mandatory laboratory … Pseudomembranous Enterocolitis: Test and Diagnosis

Pseudomembranous Enterocolitis: Drug Therapy

Therapeutic targets Elimination of the pathogens Rehydration (fluid balance) Termination of diarrhea (diarrhea) Therapy recommendations Discontinuation of the antibiotic causing the disease! Symptomatic therapy including fluid replacement Oral rehydration for signs of dehydration (fluid deficiency; >3% weight loss): administration of oral rehydration solutions (ORL), which should be hypotonic, between meals (“tea breaks”) for mild to … Pseudomembranous Enterocolitis: Drug Therapy

Pseudomembranous Enterocolitis: Diagnostic Tests

Mandatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnostics. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnosis. Gastroscopy (gastroscopy) – for severe infections with negative C. difficile detection, atypical courses, etc.

Pseudomembranous Enterocolitis: Therapy

General measures Isolation measure, i.e. accommodation in single room (cohort isolation) with own wet room. If necessary, cohort isolation for patients with the same pathogen type. Wearing protective gowns / disposable gloves for close patient contact. Careful hand hygiene (in addition to (in addition to hand disinfection washing hands with soap, as alcohol-based disinfectants do … Pseudomembranous Enterocolitis: Therapy

Pseudomembranous Enterocolitis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of pseudomembranous enterocolitis (Clostridium difficile-associated diarrhea or Clostridium difficile infection, CDI). Family history What is the general health status of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social anamnesis … Pseudomembranous Enterocolitis: Medical History