Spore Sean — Clostridioides difficile & Isolation Precautions
Watery diarrhea after antibiotics — soap and water, not hand sanitizer
Sean has had seven watery, foul-smelling stools since yesterday, just two weeks after finishing antibiotics for pneumonia. His abdomen is tender and distended.
Sean finished a course of broad-spectrum antibiotics for a respiratory infection, which wiped out his normal gut flora and let C. difficile spores take over. C. diff produces toxins that cause profuse, foul-smelling watery diarrhea and can progress to life-threatening colitis. Because C. diff forms spores, alcohol-based hand sanitizer does NOT kill it — only soap-and-water hand hygiene physically removes the spores, and contact precautions with a dedicated, dedicated-cleaned room are required.
Read Spore Sean's full story →The story arc
The setup
Sean's ten-day course of broad-spectrum antibiotics for pneumonia disrupts the normal balance of bacteria in his colon.
The turn
A few days after finishing antibiotics, Sean develops loose stools that he brushes off as a stomach bug.
The crisis
He now has more than six watery, foul-smelling stools a day, abdominal cramping and distention, and a low-grade fever. Stool toxin testing confirms C. difficile.
The save
Sean is placed in a private room on contact precautions with a dedicated stethoscope and equipment, everyone washes with soap and water before and after entering, and oral vancomycin or fidaxomicin is started while the offending antibiotic is stopped if possible.
NCLEX study section — Clostridioides difficile & Isolation Precautions
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Safety & Infection Control
Take this chapter into practice questions on the same topic.