Clinical case of severe pseudomembranous colitis caused by pathogenic infection Clostridium Difficile

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.