A 35-year-old man develops diffuse abdominal pain and nonbloody, watery diarrhea. He has 4 bowel movements per day but no nausea or vomiting. He was admitted for open reduction and internal fixation of a displaced fracture of the left humerus. The surgery and immediate postoperative course were uncomplicated. He appears ill. His temperature is 38.5°C (101.3°F), pulse is 95/min, respirations are 19/min, and blood pressure is 110/70 mm Hg. The lower abdomen is tender with guarding but without distention. His hemoglobin concentration is 13.5 g/dL and leukocyte count is 21,000/mm3. Stool analysis is pending. A CT scan of the abdomen with contrast shows a thickened edematous colon with trapping of contrast material between haustral folds. Which of the following pathogens is most likely responsible for this patient's current condition?

Question

Quizplus · Accepted Answer

Eductional Objective: Clostridioides (formerly Clostridium) difficile infection is associated with yellow-white, patchy pseudomembranes on the bowel mucosa.  These pseudomembranes consist of a neutrophil-predominant inflammatory infiltrate, fibrin, bacteria, and necrotic epithelium.  Patients may develop a nonobstructive colonic dilation known as toxic megacolon, which can lead to colonic perforation.

A 35-Year-Old Man Develops Diffuse Abdominal Pain and Nonbloody, Watery