Clostridium difficile Chris Molitor

Case Study• Jerry a 40 year old man has been reporting ongoing diarria and blood in his

stool for three days. He also complains of fatigue, occasional chills, and intermittent lower left abdominal pain and cramping. He has just finished a 10 day treatment of cefuroxime axetil to treat a painful sore throat.

• Lab Work • WBC: 9,700 cells/mm3 with 75% PMNs, 13% lymphocytes, 11% monocytes, 1% basophils• Hemoglobin: 15.5 g/dL• Hematocrit: 45.6%• Platelets: 158,000 cells/mm3• Stool Analysis: (+) occult blood, moderate WBCs

What is your Diagnosis?• Any Additional Test?

Clostridium difficile • Clostridium difficile produces an NAD-

specific glutamate dehydrogenase (GDH), which converts l-glutamate into α-ketoglutarate through an irreversible reaction

• C. diff can be accurately diagnosed using a glutamate dehydrogenase assay.

Glutamate Dehydrogenate

• Clostridium difficile is an opportunistic bacteria that usually arises in those with damaged normal flora. • Taking antibiotics killed the good bacteria in jerry’s colon making him

more susceptible to a C. diff infection.

Sources• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917229/• http://www.mayoclinic.org/diseases-conditions/c-difficile/diagnosis-tr

eatment/diagnosis/dxc-20202420• http://www.ashp.org/DocLibrary/Bookstore/P4924/Sample-Case.pdf• https://vector.childrenshospital.org/2015/01/frozen-poop-pill-offers-

a-less-invasive-treatment-option-for-emerging-infectious-disease-2/