Following acute pharyngitis, a patient was on broad spectrum antibiotics. One week later he developed watery diarrhoea with a foul odour and abdominal cramps. Antibiotic induced colitis is confirmed. What is the most common cause of antibiotic induced colitis?
Esch. coli
Clostridium difficile
Salmonella
Campylobacter jejuni
Clostridium difficile is the major known cause of nosocomial antibiotic-associated diarrhea and colitis. The organism elaborates at least four toxins, including toxin A (an enterotoxin) and toxin B (a cytotoxin). Symptoms and signs include diarrhea, which is usually watery, occasionally bloody, and has a characteristic foul odor; abdominal cramps; vomiting; fever; and leukocytosis. Demonstration of C difficile cytotoxin in the stool is sensitive and specific. Ref: Chang G.J., Shelton A.A., Welton M.L. (2010). Chapter 30. Large Intestine. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.