Colitis Pseudomembranosa por Clostridium Difficile

Abstract

Clostridium difficile infection has become one of the leading causes of diarrhea associated with antibiotic use both in patients treated as outpatients and inpatients. The etiology of this disease is due to the involvement of the intestinal microbiota and reduction of gut resistance to colonization by this pathogen. The clinic is variable can be asymptomatic or watery diarrhea, abdominal pain, fever and dehydration. Complications have pseudomembranous colitis, toxic megacolon, fulminant colitis, sepsis and lead to death. Given the severity of the disease it is very important to study in children to prevent serious complications affecting the child's welfare and development. This clinical case corresponds to a male patient 1 year 8 months old, without prenatal history, whose mother reported that eight days before admission presented thermal rise unquantified, for which self medicated paracetamol with the fever subsided partially. Then it presents diarrheal stools for 3 times in small quantities, without mucus and blood, so it comes to optional prescriber metamizol, tianfenicol and oral rehydration salts at doses not remember Despite treatment the symptoms remains what is hospitalized in the city of Bath diagnosed with intestinal infection, not receiving specific treatment for three days. The symptoms persists and is accompanied by bloody stool, watery diarrhea, abundant with removal of membranous rest so he transferred to the Pediatric Hospital of IESS Ambato. During his hospital stay laboratory studies reporting CBC are performed: marked leukocytosis + lymphocytosis, PCR high, coproparasitario reports occult blood positive stool, decreased normal bacterial flora, pathological study of anatomical remains expelled done along with your stool fibrin same reporting remains and bacterial purulent foci. Later study of Clostridium difficile toxin positive result is performed, after several days of hospitalization the patient has persistent hyponatremia, vancomycin administered for seven days, after which patient has good response to treatment. During the development of this clinical case we specify in detail the evolution and the patient had complications during their hospital stay.