Open AccessToxic megacolon from hypervirulent Clostridium difficile infection (ribotype 027) following elective total knee replacement: an emerging challenge in modern health care
Author(s) -
Buchi Arumilli,
Prasanthi Koneru,
Irfan Fayyaz
Publication year - 2010
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.06.2009.2017
Subject(s) - medicine , toxic megacolon , clostridium difficile , megacolon , sepsis , intensive care unit , intensive care medicine , infection control , disease , emergency medicine , surgery , ulcerative colitis , antibiotics , microbiology and biotechnology , biology
We present a rare case of community acquired (presenting in hospital on the day of admission or within 48 h of admission) Clostridium difficile infection (CDI) with the hypervirulent (ribotype 027) strain causing toxic megacolon in a patient, diagnosed on the third postoperative day following an elective total knee replacement. The patient did not have any of the commonly reported risk factors for CDI. The source of sepsis was initially presumed to be the operated prosthetic joint, and this caused a delay in the correct diagnosis and institution of appropriate antimicrobial treatment which may have contributed to a poorer outcome. This case highlights the risk of patients arriving from the community manifesting life threatening CDI in the hospital.