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Pseudomembranous colitis: symptoms
Last reviewed: 23.04.2024
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The duration of the incubation period is unknown. In one study, it was shown that the symptoms of pseudomembranous colitis occurred on the 2-60th day (an average of 20.3) of hospitalization. C. Difficile can cause a variety of clinical manifestations of varying severity from asymptomatic carriage, mild-to-severe or severe diarrhea to life-threatening colitis. The main symptoms of watery diarrhea (at least three times a day for several days), fever, lack of appetite, nausea, pain or tension in the abdomen. The medium-heavy course is characterized by non-arthritic diarrhea, systemic manifestations are absent, and tenderness in the abdomen is noted. Heavy currents differ profuse watery diarrhea, pain and tension in the abdomen. Frequent fever, dehydration, in the stool reveal hidden blood, but intestinal bleeding is not characteristic.
[Diarrhea
Usually the stool is watery in nature, more than 7 times during the day. Usually, diarrhea appears 4 to 9 days after antibiotics are started, but can occur during the first 24 hours and even after a single use of the antibiotic with a preventive purpose. Approximately 20% of patients develop diarrhea after 6 weeks or more after the end of antibiotic use. The stool can be with a trace of blood. Approximately 50% of patients in the stool samples have a large number of leukocytes.
Pain in abdomen of spastic character
Usually, when examining the abdomen, tenderness is noted, without signs of irritation of the peritoneum.
Fever
The temperature can rise to 39-40 ° C.
Laboratory data
Often there is leukocytosis with a leukemoid reaction, hypoalbuminemia.
The course of the disease in the absence of treatment can be different. In some patients, diarrhea of varying severity is noted, which stops after antibiotic withdrawal. Some may develop chronic diarrhea, which lasts several weeks or months. In most patients, fever, abdominal tenderness, leukocytosis and hypoalbuminemia are noted.
Complications of pseudomembranous colitis
In severe course, pseudomembranous colitis, dynamic (paralytic) intestinal obstruction, toxic megacolon, large intestine perforation, severe electrolyte disturbances, dehydration, hypoalbumism and anasarca can occur. In some patients, diarrhea manifestations may be minor or absent, but a toxic megacolon, large intestine perforation and peritonitis may occur. In these cases, against a background of increasing signs of inflammation, diarrhea may stop. Such patients need to consult a surgeon, since if a toxic megacolon develops, about 60% of patients need surgery, and the lethality in this group increases to 32-50%.