Surgical outcome of community-acquired Clostridium difficile colitis presenting as toxic megacolon: case report

Andrea P Mann, Andrew McCague, Fariborz Lalezarzadeh
Surgical Infections 2011, 12 (4): 317-20

BACKGROUND: Over the past decade, there has been an increase in both community-acquired and health-care-associated Clostridium difficile colitis secondary to broad-spectrum antibiotic exposure. Toxic megacolon is a rare complication of pseudomembranous colitis that often necessitates emergency colectomy.

METHODS: Review of the pertinent English-language literature.

RESULTS: We present a case of community-acquired C. difficile colitis that made its initial presentation as fulminant toxic megacolon. Six months after a total colectomy, the patient has no complaints.

CONCLUSION: Prompt total colectomy may improve survival in patients with toxic megacolon. The incidence of C. difficile-related toxic megacolon and post-operative outcomes of total colectomy should be investigated in a larger observational study.

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