要約

• Infection of the colon caused by the bacteria Clostridium difficile in patients whose normal bowel flora has been disrupted by recent antibiotic use.
• Patients usually present with diarrhoea, abdominal pain, and leukocytosis, and a history of recent antibiotic use. Other common symptoms include fever, abdominal tenderness, and distension.
• Diagnostic standard is stool cytotoxin tissue culture assay. Most laboratories use stool enzyme immunoassay for toxins A and B. May be evidence of pseudomembranes on sigmoidoscopy or colonoscopy in some patients.
• Treatment is to discontinue the implicating antimicrobial agent and begin oral metronidazole or vancomycin.
• About 5% to 20% of treated patients have recurrence after discontinuation of therapy, but most respond to a second course of therapy.