A Case Report on Fulminant Clostridium difficile Colitis Managed with Vancomycin Administered through Ileostomy
Faris Hussain, P Shihabudheen, Noushad Babu, Nihal Muhammed, Vivek Prasad, EP Ashique, IP Shahsadhi, FT Shana
Keywords :
Clostridium difficile, Ileostomy, Intensive care unit, Vancomycin retention enema, Sepsis
Citation Information :
Hussain F, Shihabudheen P, Babu N, Muhammed N, Prasad V, Ashique E, Shahsadhi I, Shana F. A Case Report on Fulminant Clostridium difficile Colitis Managed with Vancomycin Administered through Ileostomy. 2023; 2 (3):66-68.
Clostridium difficile (CDF) is a widespread nosocomial infection, usually presented as diarrhea. In fulminant cases, paralytic ileus is common. In postoperative patients with a functioning ileostomy, it is rare. Here, we describe a patient who was admitted with features of septic shock secondary to ileal obstruction and perforation. Since the patient was in sepsis, not responding to broad-spectrum antibiotics and antifungals, and computed tomography (CT) showed edematous bowel loops, we suspected CDF. Investigations confirmed pseudomembranous enterocolitis and responded to treatment which included oral vancomycin along with intravenous (IV) metronidazole and vancomycin as retention enema through rectum, and ileostomy downwards using Foley's catheter. This case report is a newer insight to prompt decision-making and intervention than those described in the conventional treatment algorithm of Clostridium difficile infection (CDI).
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