Pseudomembranous Colitis | Western Sydney University - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

127

Pages:

2
Author:

Mariam A. A.

Pseudomembranous colitis Definition: • • Inflammation of the colon that is associated with an overgrowth of C. difficile. It can also be referred to as antibiotic-associated colitis or antibiotic-associated diarrhoea. Risk factors. • • • Advanced age Hospitalization: due to high prevalence -> 30% of hospitalised adults are colonise dby this pathogen. Antibiotic treatment Pathogenesis: Disruption of normal colonic microbiota by antibiotics or immunosuppression -> C. difficile overgrowth -> c. difficile releases toxins -> ribosylation of small GTPases such as Rho -> disruption of the epithelial cytoskeleton, tight junction barrier loss and cytokine release and apoptosis. Morphology • • • • • Formation of pseudomembranous made up of adherent layer of inflammatory cells and debris at cites of colonic mucosal injury. While there are not specific and may occur in ischemia or necrotising infections, the histopathology of c. difficile-associated colitis is pathognomonic. The surface epithelium is denuded and the superficial lamia propria contains dense infiltrate of neutrophils and occasional fibrin thrombi within capillaries. Superficially damaged crypts are distended by a mucopurulent exudate that froms an eruption reminiscent of a volcano. These exudates coalesce to form pseudomembranous. Clinical features • • • • • • • • • Fever Leucocytosis Abdominal pain Cramps Watery diarrhea Dehydration Faecal leukocytes Occult blood. Grossly bloody diarrhoea is uncommon. Diagnosis • Detection of toxin rather than culture. Management and treatment • • • Vancomycin Metronidazole New antibiotics, monoclonal antibiotics against toxin A and B and fecal microbial transplants can be effective treatments. - However, the use of these is not widespread yet. Challenges • • Becoming increasing antibiotic resistant Recurrence rate of 40%.

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