Case Study Overview

An elderly lady, of no fixed abode, arrived at the hospital’s emergency department after having fallen. She was admitted to hospital for fixation of a fracture of the hip. Shortly after admission she developed signs of a chest infection and was started on a cephalosporin, which she remained on for a week. Subsequently she developed profuse watery diarrhoea and abdominal pain. A faeces sample was sent to the laboratory to test for the toxins of Clostridium difficile, which proved positive and she was commenced on oral vancomycin. Despite treatment the diarrhoea persisted and it also failed to respond to a course of metronidazole. The condition of the patient worsened and a sigmoidoscopy was performed, revealing that she had pseudomembraneous colitis. Her clinical condition deteriorated and she developed megacolon and an emergency colectomy was performed.