Clostridium difficile Infection
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Benign Disease- A 29-year-old HIV-positive man presents to the emergency department with intermittent fever, abdominal pain, weight loss, and bloody diarrhea. Diagnostic colonoscopy is performed, and biopsies of several colonic ulcers confirm cytomegalovirus (CMV). Which of the following is the first-line treatment for this patient?
- A 57-year-old woman is admitted to the intensive care unit with abdominal distention, diarrhea, and hypotension. Evaluation is significant for white blood cell count of 38,000/mL, lactate of 2.5 mmol/L, and stool cultures positive for Clostridium difficile (C. diff) infection. Computed tomography shows diffuse thickening of the ascending and transverse colon. What is the best surgical intervention?
- A 32-year-old patient on inflixmab for maintenance therapy of ulcerative colitis (UC) is admited to the hospital with abdominal pain, six bloody stools daily, temperature of 38 ºC, and heart rate of 100 beats per minute. Colonoscopy demonstrates pancolitis with erythema, ulcerations, and scattered pseudopolyps. The best next step in treatment is intravenous (IV)
- A 38-year-old man returns from a 1-week trip to Africa, where he had sampled the local cuisine and drank the water. On his return, he develops fever and bloody diarrhea. Other symptoms included abdominal pain, nausea and vomiting. His symptoms did resolve independently over the course of the next week. Within a few days of gastrointestinal symptom resolution, the patient developed neurologic symptoms consistent with Guillan-Barre syndrome. Which of the following gastrointestinal illnesses is he most likely to have contracted?
- A 46-year-old man presents as an inpatient consult for persistent watery diarrhea, nausea, and abdominal cramps. The patient has a history of acute myeloblastic leukemia and received an allogeneic stem cell transplant 6 months ago. The patient notes compliance with his immunosuppression medications. The most common cause of diarrhea in this patient is most likely caused by which of the following?
- A 75-year-old woman presents with abdominal pain and multiple episodes of diarrhea starting 24 hours prior to presentation. She has had two episodes of Clostridium difficile (C. diff) infection (CDI) in the past 3 months. Stool studies show positive C. diff toxin enzyme immunoassay. Which of the following is the best next step in the treatment of this patient?
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