Clostridioides difficile infection leading to fulminant colitis with toxic megacolon
DOI:
https://doi.org/10.4322/acr.2023.457Keywords:
Colectomy, Colitis, Colorectal Surgery, Diarrhea, PseudomembranousAbstract
Clostridioides difficile infection (CDI) is the culprit of millions of nosocomial infections in the United States. Programs
that successfully decrease its incidence, therefore, render cost savings for the healthcare system. Toxic megacolon and
perforation are two of the most significant complications with increased mortality rates. We report a 23-year-old nursing
home resident hospitalized for fever, cough, and green sputum. After 3 days of antibiotic therapy, he developed abdominal
distension, diarrhea, and vomiting and underwent a total colectomy. The colon was dilated to a maximum of 11 cm
with markedly edematous mucosa and yellow pseudomembranes. Qualitative PCR of the stool detected Clostridioides
difficile toxin B gene. While there is no consensus for the required interval between antibiotic treatment and CDI, this
presentation 3 days after starting the antibiotic therapy is earlier than most proposed ranges.
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