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Danielle's Difficulty

Risks, Treatments, and Prevention of Clostridium difficile


Dorothy P. Debbie
Department of Microbiology and Immunology
Cornell University College of Veterinary Medicine


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.

  • Identify the risk factors for development of C. difficile disease.
  • Discuss and evaluate treatment options for recurrent C. difficile disease.
  • Develop and discuss methods to prevent the spread of C. difficile infection in the institutional setting (e.g., hospital, nursing home, rehab center).
  • Describe the mechanisms of action of the various toxins of C. difficile and explain their contributions to the different disease spectrums caused by C. difficile.
Keywords: Clostridium difficile; bacteria; diarrhea; toxins; infectious disease; bacterial disease; pathogenesis; antibiotics
Topical Area: N/A
Educational Level: Undergraduate upper division, Professional (degree program)
Formats: PDF
Type/Method: Discussion, Interrupted
Language: English
Subject Headings: Microbiology   Medicine (General)   Epidemiology   Public Health   Pharmacy / Pharmacology   Biology (General)   Nursing  
Date Posted: 10/17/2013
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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