Téma:  Case Studies

Case reports of patients with clostridium difficile toxin a-associated disease

Ján Koreň, Michal Koreň

Nowadays nosocomial infections become increasingly apparent and media present them like dangerous even fatal infections, which can be acquired in the healthcare facilities. Clostridium difficile (C. difficile) is approximately in one-third hospitalized patients’ carrier strain(1). This anaerobe spore-forming bacterium remains in patients even during specific therapy and in the vegetative form it produces toxin A and B. Spores are resistant to the most of disinfectants in the hospital setting. These are the reasons for frequent relapses or re-infections as repeated diarrhea and other symptoms after the primo infection treatment. A case report of the first patient with polymorbidity points on relapse associated with C. difficile toxin A by six hospitalization can lead, as one of other risk factors, to the lethal end. In the second elderly female patient the disease was in due time diagnosed. Specific effective therapy was accordingly prescribed and she was discharged in good condition to the ambulatory care. We emphasize the importance of prevention, respect of hygienic - epidemiological regime, barrier technique, rational antibiotics indication, timely proof in desirable stool examination of C. difficile toxin A and overpass on a specific effective therapy - metronidazole, vancomycin. Similarly, relapse prevention is important in risk patients.

Ročník 2009  Témy časopisu Internal medicine 10 / 2009

CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ivica Lazúrová, CSc. FRCP

REPRESENTATIVE OF CHAIRMAN
prof. MUDr. Juraj Payer, CSc., FRCP

MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett ́ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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c. propionibacterium acnes
d. endothelial growth factor


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