Fulminant Clostridium Difficile Colitis In A Patient With Spinal Cord Injury: Case Report

Abstract

Background:ln certain patients with Clostridium difficile colitis (CDC), a life-threatening systemictoxicity may develop despite appropriate and timely medical therapy.

Design:Literature search and case report.

Findings: A 39-year-old man with Tl0 paraplegia presented with a distended, quiet abdomen followingrecent treatment withantibiotics for pneumonia. Diarrhea was not present. Complete blood counts demonstrated a marked leukocytosis. A CT scan of theabdomen demonstrated a state of diffuse pancolanie inflammation with peritoneal fluid . The patientwas taken to the operating roomand underwent total abdominal colectomy with oversewing of the rectal stump and end ileostomy for treatment of the fulminant CDC.

Conclusion:Patients with spinal cord injury (SC I) often receive antibiotics for infections of the aerodigestive tree and urinary tractand for problems with skin integrity. A heightened awareness of the development of fulminant CDC remains essential in the care ofpatients with SCI. Any unexplained abdominal illness after recent antibiotic administration should alert the physician to CDC and itspotential as a fulminant, potentially fatal illness.