Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 25: A Patient in the Midst of an Inflammatory Bowel Disease Flare Also Was Positive for Clostridium difficile. How Often Does This Happen and What’s the Best Way to Manage This Scenario? (continued)

Brian Mulhall, MD

Clostridium difficile is the leading cause of hospital-acquired diarrhea. During the past decade, there has been an increase in the incidence of community-based C. difficile infections, and antibiotic resistance has increased. C. difficile can cause colitis itself, often referred to as pseudomembranous colitis, due to the plaques that adhere to the colonic mucosa (Figure 25-1). This infection can also occur in patients who have underlying inflammatory bowel diseases (IBD), like ulcerative colitis or Crohn’s disease.1 Patients with IBD are often treated with antibiotics and immunomodulators…