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Hi,

C-diff (that's short for clostridium difficile) is a bacterium, that

can become dangerous when it causes a colitis (inflammation of the

colon). That's quite a risk for pwcf since the constant use of

antibiotics is the main reason for c-diff colitis.

Peace

Torsten

Can J Gastroenterol. 2001 Sep;15(9):586-90. Related Articles, Links

Colonic disorders in adult cystic fibrosis.

Chaun H.

St 's Hospital and University of British Columbia, 805 West

Broadway, Vancouver, British Columbia V5Z 1K1, Canada.

hchaun@...

By 1996, the median survival of patients with cystic fibrosis (CF) in

North America had increased to 31 years. With the markedly improved

life expectancy, many CF patients are now adults. There is an

associated increased risk of certain colonic disorders, and the

emergence of other previously unrecognized disorders, in adult CF

patients. The distal intestinal obstruction syndrome (DIOS), which is

more common in older patients, is a frequent cause of abdominal pain.

Intussusception may complicate DIOS; other differential diagnoses

include appendiceal disease, volvolus, Crohn's disease, fibrosing

colonopathy and colonic carcinoma. The diagnosis of acute

appendicitis, although uncommon in patients with CF, is often

delayed, and appendiceal abscess is a frequent complication. The

prevalence of Crohn's disease in CF has been shown to be 17 times

that of the general population. Right-sided microscopic colitis is a

recently recognized entity in CF of uncertain clinical significance.

Fibrosing colonopathy has been confined mostly to children with CF,

attributed to the use of high strength pancreatic enzyme supplements,

but it has been reported in three adults. Nine cases of carcinoma of

the large intestine have been reported worldwide, associated with an

apparent excess risk of digestive tract cancers in CF. Despite high

carrier rates of Clostridium difficile in patients with CF,

pseudomembranous colitis is distinctly rare, but severe cases

complicated by toxic megacolon have been reported. In these patients,

watery diarrhea is often absent. Adult CF patients with refractory or

unexplained intestinal symptoms merit thorough investigations.

AJR Am J Roentgenol. 1999 Feb;172(2):517-21. Related Articles,

Links

Atypical presentation of Clostridium difficile colitis in patients

with cystic fibrosis.

Binkovitz LA, E, Bloom D, Long F, Hammond S, Buonomo C,

Donnelly LF.

Department of Radiology, Columbus Children's Hospital, OH 43205, USA.

OBJECTIVE: This report describes the unusual presentation of

Clostridium difficile colitis in five patients with cystic fibrosis

and the role of CT in first suggesting the correct diagnosis in this

group of patients. Because of the absence of watery diarrhea and the

presence of abdominal bloating and decreased stooling, cystic

fibrosis patients with C. difficile colitis will be treated for stool

impaction, meconium ileus equivalent, or distal intestinal

obstruction syndrome. CT of the abdomen, performed in these five

patients because of their lack of improvement after standard therapy

for stool impaction, showed an extensive pancolitis later confirmed

to be caused by C. difficile infection. CONCLUSION: In patients with

cystic fibrosis, imaging findings of a pancolitis should raise the

possibility of C. difficile colitis despite the lack of watery

diarrhea. Anticlostridial treatment can be initiated before

bacteriologic confirmation is obtained.

PMID: 9930816 [PubMed - indexed for MEDLINE]

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Our 7 month old daughter has had a c-diff infection since April.

Can anyone help me understand what all this information means. Our

daughter has been on Flagyl for the c-diff, but they do also use

Vanco if necessary. Now, I'm wondering if we shouldn't pull in the

big V (rather than just the Flagyl) to totally eridicate it. The

Dr. told us he wants to " save " Vanco for future lung infections.

Any advise???

> Hi,

>

> C-diff (that's short for clostridium difficile) is a bacterium,

that

> can become dangerous when it causes a colitis (inflammation of the

> colon). That's quite a risk for pwcf since the constant use of

> antibiotics is the main reason for c-diff colitis.

>

> Peace

> Torsten

>

> Can J Gastroenterol. 2001 Sep;15(9):586-90. Related Articles,

Links

>

>

> Colonic disorders in adult cystic fibrosis.

>

> Chaun H.

>

> St 's Hospital and University of British Columbia, 805 West

> Broadway, Vancouver, British Columbia V5Z 1K1, Canada.

> hchaun@c...

>

> By 1996, the median survival of patients with cystic fibrosis (CF)

in

> North America had increased to 31 years. With the markedly

improved

> life expectancy, many CF patients are now adults. There is an

> associated increased risk of certain colonic disorders, and the

> emergence of other previously unrecognized disorders, in adult CF

> patients. The distal intestinal obstruction syndrome (DIOS), which

is

> more common in older patients, is a frequent cause of abdominal

pain.

> Intussusception may complicate DIOS; other differential diagnoses

> include appendiceal disease, volvolus, Crohn's disease, fibrosing

> colonopathy and colonic carcinoma. The diagnosis of acute

> appendicitis, although uncommon in patients with CF, is often

> delayed, and appendiceal abscess is a frequent complication. The

> prevalence of Crohn's disease in CF has been shown to be 17 times

> that of the general population. Right-sided microscopic colitis is

a

> recently recognized entity in CF of uncertain clinical

significance.

> Fibrosing colonopathy has been confined mostly to children with

CF,

> attributed to the use of high strength pancreatic enzyme

supplements,

> but it has been reported in three adults. Nine cases of carcinoma

of

> the large intestine have been reported worldwide, associated with

an

> apparent excess risk of digestive tract cancers in CF. Despite

high

> carrier rates of Clostridium difficile in patients with CF,

> pseudomembranous colitis is distinctly rare, but severe cases

> complicated by toxic megacolon have been reported. In these

patients,

> watery diarrhea is often absent. Adult CF patients with refractory

or

> unexplained intestinal symptoms merit thorough investigations.

>

>

>

> AJR Am J Roentgenol. 1999 Feb;172(2):517-21. Related Articles,

> Links

>

>

> Atypical presentation of Clostridium difficile colitis in patients

> with cystic fibrosis.

>

> Binkovitz LA, E, Bloom D, Long F, Hammond S, Buonomo C,

> Donnelly LF.

>

> Department of Radiology, Columbus Children's Hospital, OH 43205,

USA.

>

> OBJECTIVE: This report describes the unusual presentation of

> Clostridium difficile colitis in five patients with cystic

fibrosis

> and the role of CT in first suggesting the correct diagnosis in

this

> group of patients. Because of the absence of watery diarrhea and

the

> presence of abdominal bloating and decreased stooling, cystic

> fibrosis patients with C. difficile colitis will be treated for

stool

> impaction, meconium ileus equivalent, or distal intestinal

> obstruction syndrome. CT of the abdomen, performed in these five

> patients because of their lack of improvement after standard

therapy

> for stool impaction, showed an extensive pancolitis later

confirmed

> to be caused by C. difficile infection. CONCLUSION: In patients

with

> cystic fibrosis, imaging findings of a pancolitis should raise the

> possibility of C. difficile colitis despite the lack of watery

> diarrhea. Anticlostridial treatment can be initiated before

> bacteriologic confirmation is obtained.

>

> PMID: 9930816 [PubMed - indexed for MEDLINE]

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