VS: fever; tachycardia; tachypnea. PE: moderate dehydration; mild abdominal tenderness with no signs of peritoneal irritation; surgical wound normal.
CBC: leukocytosis. Stool culture reveals gram-positive rods, Clostridium difficile; presence of toxin in stool.
Sigmoidoscopy: mucosal hyperemia, ulcers, and pseudomem-branes.
Mucosa hyperemic and swollen; epithelial ulcerations covered by yellowish plaques (pseudomembranes) and fibrinous exudate.
Fibrinous exudate with pseudomembrane formation; ulceration of superficial epithelium; neutrophilic infiltrate with necrotic debris.
Cessation of offending antibiotic; give metronidazole or oral vancomycin.
Pseudomembranous colitis is defined as acute inflammation of die colon in patients taking antibiotics, specifically clindamycin or ampicillin, due to overgrowth of C. difficile; it is characterized by formation of pseudomembranes. Clindamycin acts by blocking protein synthesis at the 50S ribosomal unit. Its main clinical indication is for life-threatening infections with anaerobes.
Was this article helpful?