Klin Onkol 2009; 22(3): 108-116.
Summary
Backgrounds: Clostridium difficile associated diarrhoea/disease (CDAD) is an inflammatory disease of the colon. It affects patients who have been exposed to wide-spectrum antibiotics and long‑term in‑patient care, with immunosuppression. The most difficult form of this disease is manifested as pseudomembranous enterocolitis, it runs fulminantly in significant events. In recent years there has been an increase in the incidence of this disease worldwide. Several serious epidemics caused by virulent strains of Clostridium difficile have been discovered in Western Europe, North America and Asia. Patients and Methods: We observed an increased occurrence of this disease at our clinic during 2004–2007. A group of 36 patients with CDAD was analyzed in the article. Patients with different severity courses were identified in the group – from slightly running post‑antibiotic diarrhoe a to serious pancolitis with the manifestati on of sepsis and MODS (multiple organ dysfunction syndrome). Materials and methods: It is a retrospective analysis of a patients’ group with CDAD. Results and conclusions: According to our experience, in the group of oncological patients, post‑antibiotic clostridi a diarrhoe a often develops in a very complicated and protracted way. It also affects relatively young patients. Protein malnutriti on and febrile neutropenia have a significant occurrence during its genesis. A higher risk of CDAD is found in the group of patients with malignant lymphomas and colorectal malignancy. 20% of our patients did not have any previous ATB exposure, so we can express the theory of oncology therapy as a predisposition factor of CDAD. The CDAD relevance in oncological patients cannot be evaluated according to leukocytosis (a significant part of febrile neutropenia in our group). The disease could require a combined causal therapy and intensive supporting treatment. There is a higher risk of heavy MODS illness course in the group of oncological patients. The article also deals with the case report of one complicated case.
