Fulminant C diff infection

We discussed a case about an elderly woman w/ recent hospitalization for pneumonia, who presented w/ acute watery diarrhea, fevers, and encephalopathy, found to be in septic shock due to fulminant C diff colitis.

Disease severity

Treatment (2021 IDSA Updated Guidelines)

  • Updated IDSA guidelines recommend Fidaxomicin over Vancomycin in nonfulminant C diff infection. Can still treat with PO Vancomycin.
    • But fidaxomicin is $$$$, which can be a barrier
  • For recurrent C diff infections: If prior C diff infection was w/in the last 6 months, treat with adjunctive Bezlotoxumab

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