answer all of them with details An 83-year-old female patient presented in the E

Question

answer all of them with details

An 83-year-old female patient presented in the ER with signs of dehydration such as sunken eyes, dry mucus membranes and low urinary output due to frequent watery diarrhea (five to 10 times a day), for two days. Her stools had turned bloody with mucus in them. At the start of her diarrhea she was given Loperamide at the nursing home she lived in, but the frequency of her diarrhea increased, and she started developing abdominal cramps and bloating .When the doctor took her medical history, she discovered that her patient had completed a course of Clindamycin for a bad sinus infection. The doctor immediately ordered stool tests, enzyme immunoassays for toxins and a colonoscopy. The colonoscopy revealed yellowish adherent plaques, 2–10 mm, called pseudomembranes with a few areas of normal mucosa between them. Her doctor immediately started her on aggressive antibiotic therapy with Metronidazole andVancomycin. The patient subsequently recovered well enough to be discharged.

Prompts:

1) What disease did the doctor suspect?

2) What is the casual organism for this disease?

3) What are the pre-disposing or risk factors for this disease?

4) What toxins would the ELISA test detect?

5) What were the other tests done?

Explanation / Answer

1. The disease suspected by the doctor is pseudomembranous colitis. Since the patient had completed a course of clindamycin and also the age of patient is 80. Psudomembranous colitis has been reported as a sideffect of clindamycin. The sign and symptoms of pseudomembranous colitis include, watery diarrhoea, abdominal cramp, bloody stool, mucus in stool, dehydration nausea and fever.

2. Clostridium difficile (C difficile) bacteria

3. The risk factor for pseudomembranous colitis inclde use of antibiotics, increasing age, weak immune system, colone disease, intestinal surgery, chemotherapy treatment for cancer.

4. Toxins A and B.  Clostridium difficile (C difficile) produces tOxins A and B which are highlly sensitive towards ELISA test.

5. The other tests include electrolyte level, complete blood count, albumin levels and serum lactate level.

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