Published 20 July 2009, doi:10.1136/bmj.b2648
Cite this as: BMJ 2009;339:b2648

Practice

Lesson of the Week

A diarrhoeal illness with a difference?

Juliet Elvy, specialist registrar1, Terry Riordan, consultant microbiologist1, Patrick Sarsfield, consultant histopathologist2, Tariq Ahmad, consultant gastroenterologist3

1 Department of Medical Microbiology, Royal Devon and Exeter Foundation NHS Trust, Exeter EX2 5AD, UK, 2 Department of Histopathology, Royal Devon and Exeter Foundation NHS Trust, 3 Department of Gastroenterology, Royal Devon and Exeter Foundation NHS Trust

Correspondence to: J Elvy juleselvy@doctors.org.uk

Colitis associated with C difficile highlights the need to consider the diagnosis in the absence of typical risk factors

The first 150 words of the full text of this article appear below.

We describe a case of a 29 year old healthcare worker who presented with a diarrhoeal illness of 3 weeks’ duration. This young woman had been passing up to seven loose stools a day with mucus but no blood. Her medical history included symptoms consistent with a diagnosis of irritable bowel syndrome with diarrhoea, but there was no particular family history of gastrointestinal disease. She lived with her partner and 11 year old daughter and worked as a student nurse in an adult mental health unit. She was a former smoker, having stopped five years previously. She had no history of foreign travel or contact with animals.

On examination she was apyrexial, pulse was 88 beats per minute, and blood pressure was 118/82 mm Hg. She was diffusely tender over the lower abdomen but had no signs of peritonism. Blood tests revealed a haemoglobin concentration of 13.5 g/dl, white cell . . . [Full text of this article]


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