Clostridium difficile-associated disease with lethal outcome in a 77-year-old woman. A case report.
Clostridium difficile-associated disease (CDAD) ranges in severity from mild diarrhoea to fulminant colitis and death. Antimicrobial use is the primary risk factor for development of CDAD. C. difficile typically affects older or severely ill patients, hospitalized or residents in long-term-care facilities. We report a case of CDAD in a 77-year-old woman operated on for cholecystitis calculosa and treated with cephalosporins and aminoglycosides. Symptoms and signs of CDAD were watery diarrhoea, mucus stool, high fever and, weakness. Sigmoidoscopy was provided on the second day after hospitalization. It revealed diffuse pseudomembranes throughout the distal colon, confirming C. difficile infection. Antimicrobial agents administered at the admission were stopped and treatment with oral vancomycin, metronidazole and famotidine was initiated. Despite this the patient's status worsened and she died because of cardiogenic shock.
Department of Hygiene, Infectious Diseases and Epidemiology, Medical Faculty, Tracian University, Stara Zagora, Bulgaria. pe_kova@yahoo.com
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Pekova
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Shomov
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Mladenova
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Pellicano
D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002764:Cholecystitis / Q000601:surgery; D016360:Clostridioides difficile; D004359:Drug Therapy, Combination; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D015738:Famotidine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D008795:Metronidazole; D015738:Famotidine; D014640:Vancomycin