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Cecal Perforation Associated with Clostridium difficile Infection: A Case Report.
Sarah Kyuragi Luthe1, Ryota Sato2
1Department of Anesthesia, Urasoe General Hospital, Okinawa, Japan.
The Journal of Emergency Medicine
|February 6, 2017
Summary
Fulminant Clostridium difficile infection (CDI) can be life-threatening, leading to severe complications. Early surgical intervention is critical for reducing mortality in severe CDI cases.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Surgical Critical Care
Background:
- Clostridium difficile infection (CDI) presents with various complications, including fulminant CDI.
- Fulminant CDI is a life-threatening condition often associated with toxic megacolon and bowel perforation.
Observation:
- A 79-year-old female presented with altered mental status and was treated for a thalamic hemorrhage.
- During hospitalization, she developed Clostridium difficile-associated diarrhea, progressing to altered mental status and septic shock despite metronidazole treatment.
- Imaging revealed toxic megacolon and pneumoperitoneum, necessitating subtotal colectomy.
Findings:
- Fulminant CDI can rapidly progress to severe complications requiring emergent surgical intervention.
- Prompt surgical management alongside antibiotic therapy is crucial for managing life-threatening CDI complications.
Implications:
- Emergency physicians must maintain a high index of suspicion for fulminant CDI complications.
- Early recognition and consideration of surgical intervention are vital for improving outcomes in patients with severe CDI.
