I need help with this case

Question Description

A 67-year-old man had surgery for a ruptured sigmoid colon

diverticulum with an abscess. A repair was done, and the

abscess was drained. He was treated with intravenous

gentamicin and ampicillin. Ten days later and 4 days after being

discharged from the hospital, the patient developed malaise,

fever, and cramping abdominal pain. He had multiple episodes

of diarrhea.. His stool was positive for occult blood and the

presence of polymorphonuclear cells. On sigmoidoscopy,

the mucosa was erythematous and appeared to be inflamed,

and there were many raised white to yellowish plaques 4-8 mm

in diameter.

Questions :-

What is the likely cause of the patient’s problem?

2. What in his history was a predisposing factor for his development of this infection? How did it predispose him?

3. Evaluate the laboratory methods for the diagnosis of Clostridium difficile infection.

4. Why culture is not useful to establish the etiology of this disease?

5. Why is this organism particularly problematic as a nosocomial pathogen?

6. Describe a disease spectrum seen with this organism. Why is it difficult to manage infections caused by this organism?

7. What virulence factors does this organism produce, and what roles do these factors play in the pathogenesis of disease?

8. Discuss three different types of therapeutic strategies that can be used to treat this disease?

9. Recurrence of this diseases occurs in 10 to 20% of patients. Give two possible explanations for why recurrences are common in this disease. What was the likely source of bacteria for the relapse that occurred in the C. difficile infection?

10Since 2000 various studies from USA, Europe and Canada revealed increased incidence of CDI and more severity of the disease than previously reported. What data support this observation? What are possible explanations for this increased virulence

Tags: b BK

Final Answer

find the attached completed paper. Please leave a good review. If you have another one please invite me to bid. Thanks

Running Head: MEDICINE


Medical Case Study


Medical Case Study

Clostridium difficile toxin is the likely cause of the patients’ problem. The treatment with
intravenous gentamicin and ampicillin was a predisposing factor to the patients' current problem.
The use of this type of treatment leads to diarrhoea, severe stomach pain, fevers and blisters in
the patients’ digestive tract. The interaction between the two medicines leads to the side effects
above that later result to a health problem as experienced by the patient.
There are various laboratory diagnostic tests of the Clostridium difficile Infection.
However, most of them have been criticized because of one or two aspects. Firstly, a Nucleic
acid amplification test (NAATs) targets the chromosomal toxin genes. This laboratory test shows
high specificity and sensitivity. In addition to that, it provides rapid results and applicable to ondemand and batch testing. However, these tests are not recommended for day to day use. The
second type of test is the two-step algorithms. This laboratory test uses glutamate dehydrogenase
(GDH) assays for screening the Clostridium. It screens the C in a stool specimen, further, a direct
cytotoxin testing follows in the identification of the toxin that is responsible in the production of
C. However, the direct cytotoxin testing is not widely available. Additionally, the method
requires 48 to 92 hours which delays the therapy time.
Culture does not play a crucial part in examining the etiology of the disease. This disease
does not relate to the cultural activities and beliefs and so; its origin cannot rely on culture. This
type of nosocomial pathogen leads to the formation of spore-formation bacteria that result in a
highly variable disease. Therefore, it is problematic since its variable and causes more harm by
multiplying rapidly to individuals afte...

Cornell University

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