Abstract
Through its specific biological, epidemiological, diagnostic and infection management features, Clostridium difficile infection (CDI) can be considered a major health concern, especially in inflammatory bowel disease (IBD) patients. In this particular infection, many IBD risk factors are triggered due to bowel inflammation, antibiotics use, microbiota changes, immunosuppressive therapy use and surgical intervention. Thus, each IBD and diarrhea patient must be tested for CDI. Clinical features show different initial infectious stages such as mild, fulminate and refractory. It has been shown that CDI presents recurrent episodes. CDI treatment consists of metronidazole, vancomycin or fidaxomicin, as well as prophylactic measures. It was recently shown that antibiotic doses must be gradually reduced in order to avoid CDI relapses. Fecal transplantation, effective in CDI management, remains controversial in CDI patients with concurrent IBD.
Highlights
Clostridium difficile (CD) is a Gram-positive, spore-producing anaerobic bacillus that was first described in children’s gastrointestinal flora (GIF)
Regarding the initial infection forms, mild or moderate disease is characterized by watery diarrhea and leukocytosis, normal albumin and creatinine serum concentrations; the severe disease is characterized by a decrease in albumin serum concentration, leukocytosis, anemia and high creatinine serum concentration due to severe diarrhea and dehydration; the fulminant or complicated disease is characterized by fever, vomiting, hypotension, abdominal distension and sudden interruption of diarrhea, severe leukocytosis, high lactate serum concentration and hypoalbuminemia; and the refractory disease presents no response to therapy and can exhibit ileus, toxic megacolon, perforation or obstruction identified by X-rays, Computer tomography (CT) or MRI scanning
It has been shown that inflammatory bowel disease (IBD) patients affected by Clostridium difficile infection (CDI) need longer and more expensive medical care that brings a fourfold higher surgical treatment (Kariv et al, 2011) and a six-fold higher mortality compared to non-IBD CDI patients (Ananthakrishan et al, 2009)
Summary
Clostridium difficile (CD) is a Gram-positive, spore-producing anaerobic bacillus that was first described in children’s gastrointestinal flora (GIF). Regarding the initial infection forms, mild or moderate disease is characterized by watery diarrhea (rarely bloody) and leukocytosis, normal albumin and creatinine serum concentrations; the severe disease is characterized by a decrease in albumin serum concentration, leukocytosis, anemia and high creatinine serum concentration due to severe diarrhea and dehydration; the fulminant or complicated disease is characterized by fever, vomiting, hypotension, abdominal distension and sudden interruption of diarrhea, severe leukocytosis, high lactate serum concentration and hypoalbuminemia; and the refractory disease presents no response to therapy and can exhibit ileus, toxic megacolon, perforation or obstruction identified by X-rays, CT or MRI scanning In this case, a surgical approach is imperative. It has been shown that IBD patients affected by CDI need longer and more expensive medical care that brings a fourfold higher surgical treatment (Kariv et al, 2011) and a six-fold higher mortality compared to non-IBD CDI patients (Ananthakrishan et al, 2009)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
