Editor's quiz: GI snapshot
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From question on page 15
The computer tomography scan revealed a toxic megacolon with pneumatosis intestinalis and portal venous gas. During subsequent laparotomy, a subtotal colectomy with ileostomy was carried out. Isolates were found positive for C. difficile and identified as the hypervirulent strain C. difficile PCR ribotype 027, toxinotype III. Three months after admission the patient gradually recovered and could be transferred to a rehabilitation centre. C. difficile is the leading cause of antibiotic-associated diarrhoea and the aetiological pathogen of pseudomembranous colitis. The clinical picture of a C. difficile infection varies from an asymptomatic carrier state to a fulminant colitis with toxic megacolon. The number of reported cases of C. difficile infections has increased over the last decade. Since 2003, outbreaks of a new hypervirulent C. difficile PCR ribotype 027, toxinotype III have been described in the USA and Canada and, more recently, in England, The Netherlands, Belgium and
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Gut 2008 57: 15.[Extract] [Full Text] [PDF]
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