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C. Diff (Risk factors (H2RA and PPI use may be a risk factor (more…
C. Diff
Risk factors
Health care exposure - hospital, LTC
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Clinical Presentation
Watery, non-bloody diarrhea commonly 3+ times per day
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systemic infection may lead to hypotension, fever, malaise
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Etiology
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Can be caused from ABX use (clindamycin, fluoroquinolones, carbapenems, 3/4th gen ceph)
can occur during, immediately after, or delayed (up to 3 months) post-ABX use
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Pathophysiology
Pathogenic disease
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plaques can become enlarged and scatted over colorectal mucosa resulting in pseudomembranous colitis
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Severity classifications
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Fulminant
hypotension, shock, ileus, megacolon
Recurrence
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Risk factors for recurrence: old are, severe underlying disease, use of ABX, use of PPI, low antibody reponse to C. diff toxins
Treatment
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Pharm
Non-severe
Vanc 125 mg PO QID x10
nausea, not suystemically absorbed
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