Clinical case of severe pseudomembranous colitis caused by pathogenic infection Clostridium Difficile
- Authors: Styazhkina S.N.1, Kapustin B.B.1, Malchikov A.Y.1, Valinurov A.A.1, Gabdrakhmanov D.I.1, Borisova E.A.1, Grichik A.S.1
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Affiliations:
- Izhevsk State Medical Academy
- Issue: Vol 39, No 4 (2022)
- Pages: 155-160
- Section: Clinical case
- URL: https://ogarev-online.ru/PMJ/article/view/110827
- DOI: https://doi.org/10.17816/pmj394155-160
- ID: 110827
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Abstract
Objective. Literature review of pseudomembranous colitis caused by pathogenic Clostridium difficile infection and description of a clinical case of pseudomembranous colitis.
Materials and methods. A clinical case of a patient with pseudomembranous colitis is presented.
Results. In a patient with multiple injuries and grade II shock, whose condition required numerous surgical interventions and intensive antibiotic therapy, after the completion of antibiotic therapy there appeared signs of pseudomembranous colitis – loose stools (up to 5 times a day), fever up to 39 ° C, signs of endogenous intoxication, A C. difficile toxin was found in faeces. Antibiotic-associated colitis was diagnosed; metronidazole 500 mg 3 times a day, activated charcoal, infusion therapy were prescribed – on the 12th day, the therapy led to recovery. During the subsequent reconstructive operation, lincomycin 600 mg was administered by infusion for prophylactic purposes, after which, 6 hours later, the patient developed a clinical picture of severe pseudomembranous colitis. A laboratory study of faeces again revealed toxin A C. difficile. The recurrence of the disease required a long-term treatment in the gastroenterology department.
Conclusions. Pseudomembranous colitis is certainly a complex pathology that is a serious hospital-acquired infection. Accurate diagnosis requires correct assessment of the patient’s condition through clinical and laboratory diagnostic methods, correct prescription of conservative treatment and choice of surgical intervention tactics.
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##article.viewOnOriginalSite##About the authors
S. N. Styazhkina
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
MD, PhD, Professor, Department of Faculty Surgery
Russian Federation, IzhevskB. B. Kapustin
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
MD, PhD, Professor, Department of Hospital Surgery
Russian Federation, IzhevskA. Ya. Malchikov
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
MD, PhD, Professor, Department of Surgical Diseases with Course of Anesthesiology and Resuscitation of Advanced Training Faculty and Occupational Retraining
Russian Federation, IzhevskA. A. Valinurov
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
postgraduate student, Department of Faculty Surgery
Russian Federation, IzhevskD. I. Gabdrakhmanov
Izhevsk State Medical Academy
Author for correspondence.
Email: Dandrik.ru@mail.ru
fourth-year student, Faculty of Medicine
Russian Federation, IzhevskE. A. Borisova
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
fourth-year student, Faculty of Medicine
Russian Federation, IzhevskA. S. Grichik
Izhevsk State Medical Academy
Email: Dandrik.ru@mail.ru
fourth-year student, Faculty of Medicine
Russian Federation, IzhevskReferences
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- Ivashkin V.T., Yushchuk N.D., Maev I.V., Lapina T.L., Poluektova E.A., Shifrin O.S., Tertychny A.S., Trukhmanov A.S., Sheptulin A.A., Baranskaya E.K., Lyashenko O.S., Ivashkin K.V. Recommendations of the Russian Gastroenterology Association for Diagnosis and Treatment of Clostridium difficile-associated disease. Russian Journal of Gastroenterology, Hepatology, Coloproctology 2016; 5: 56–65.
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