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Dorothy P. Debbie
Senior Lecturer
Department of Microbiology and Immunology
Cornell University College of Veterinary Medicine
Danielle's Difficulty: Risks, Treatments, and Prevention of Clostridium difficile

The incidence of Clostridium difficile infection (CDI), including severe infection, has increased in both institutional settings and the general community. This case study presents the story of an elderly woman who spent time in a hospital and then in a rehab center after she injured herself in a fall. The woman subsequently developed acute gastrointestinal tract symptoms and was readmitted to the hospital, where she eventually succumbed to sepsis due to CDI.  Her granddaughter Danielle subsequently developed CDI. Students are asked to discuss the risk factors for development of CDI and to consider options for treatment and prevention. The role of C. difficile toxins in the development of disease as well as its transmission and recurrence also are covered. The case was designed for an upper level undergraduate microbiology course, but could also be used for pre-medical or pre-nursing students or a medical microbiology or infectious disease course for pharmacy, medical or nursing students.