Case Study #4 Edith, a 68-year old woman, comes to the clinic requesting an eva

Question

Case Study #4 Edith, a 68-year old woman, comes to the clinic requesting an eva relatively healthy older woman in no acute distress. Her diarrhea has persist occurs 3-6 times per day. She reports some occasional nau the diarrhea often occurs with abdominal cramping and, when she degrees F. When asked if she has ever had this problem before, she says that she has when she was hospitalized for a prolonged period last year for pneumonia and she was g luation for ongoing diarrhea. She is a bout 4-days and ed for a sea, but no vomiting. The patient reports that is 99.5 - it first started was given medications checks her temperature, it to treat it. 1. Based on the patient's symptoms and history what is your diagnosis? 2. What is the BEST test to confirm this diagnosis? 3. What should the initial course of treatment for this patient be? 4. If the initial treatment fails what alternative treatment can be tried? 5. What is the most likely reason this patient developed this disease?

Explanation / Answer

The patient has a history of hospitalisation and antibiotic usage. So, the most probable diagnosis is Clostridium difficle associated diarrhea. The best method to diagnose this condition is to perform stool culture and looking for bacterial DNA and toxins The initial course of treatment for this patient include the use of antibiotics like metronidazole and vancomycin. Faecal microbiota transplantation can be done if the initial treatment fails. The risk factors are older age, hospitalisation and other health problems like pneumonia.

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