Clostridium Difficile Colitis (cont.)
How does C. difficile cause colitis?
C. difficile spores lie dormant inside the colon until a person takes an
antibiotic. The antibiotic disrupts the other bacteria that normally are living
in the colon and preventing C. difficile from transforming into its active,
disease causing bacterial form. As a result, C. difficile transforms into its
infectious form and then produces toxins (chemicals) that inflame and damage the
colon. The inflammation results in an influx of white blood cells to the colon.
The severity of the colitis can vary. In the more severe cases, the toxins kill
the tissue of the inner lining of the colon, and the tissue falls off. The
tissue that falls off is mixed with white blood cells (pus) and gives the
appearance of a white, membranous patch covering the inner lining of the colon.
This severe form of C. difficile colitis is called pseudomembranous colitis
because the patches appear like membranes, but they are not true membranes.
Not everybody infected with C. difficile develops colitis. Many infants and
young children, and even some adults, are carriers (they are infected but have
no symptoms) of C. difficile. C. difficile does not cause colitis in these
people probably because;
- the bacteria stay in the colon as non-active spores,
and
- the individuals have developed antibodies that protect them against the
C. difficile toxins.
What are the symptoms of C. difficile colitis?
Patients with mild C. difficile colitis may have:
- a low-grade fever,
- mild diarrhea (5-10 watery stools a day),
- mild abdominal cramps and tenderness.
Patients with severe C. difficile colitis may have:
- a high fever (temperature of
102°F to 104°F),
- severe diarrhea (more than 10
watery stools a day) with blood, and
- severe abdominal pain and tenderness.
Severe diarrhea also can lead to
dehydration and disturbances in the electrolytes (minerals) in the body. Rarely,
severe colitis can lead to life-threatening complications such as megacolon
(markedly dilated colon), peritonitis (inflammation of the lining of the
abdominal), and perforation of the colon.
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