Pseudomembranous colitis poses a significant challenge, especially among patients with risk factors. A clinical case of severe pseudomembranous colitis: a call for active testing in high-risk patients

Aim. Our research aimed to describe a case of pseudomembranous colitis in a patient with secondary immunodeficiency. This case stresses the crucial importance of heightened awareness among physicians from diverse specialties when managing patients with diarrhea. Methods and material: We analyzed the clinical case of a 52-year-old woman, Ms. T, who had a history of systemic psoriasis and prolonged therapy with systemic steroids. She developed a diarrhea two weeks after receiving antibiotic treatment. Results: Patient T. was admitted to a local hospital with a diagnosis of gastrointestinal infection, but testing for Clostridioides difficile was not performed After receiving symptomatic therapy, the patient was discharged with some improvement in her condition. A day later, the diarrhea recurred. However, the patient refused to be hospitalized again. Within 30 days of staying at home and using only symptomatic therapy, the patient experienced increasing weakness and dyspepsic syndrome, diarrhea persisted up to 20 times a day, which prompted her emergency hospitalization in the gastroenterology department of the Central Clinical Hospital. On admission, her condition was considered as moderately to severe with pronounced protein-energy deficiency, electrolyte disturbances and moderate dehydration. Following a comprehensive differential diagnosis, the patient was diagnosed with severe pseudomembranous colitis. Treatment commenced with targeted antibacterial, symptomatic, and pathogenetic therapies, showing initial positive results. However, severe exhaustion and microbiota translocation resulted in sepsis, prolonging her hospital stay. After a series of therapeutic and rehabilitative interventions, the patient was discharged in a satisfactory condition. Conclusion: This clinical case highlights the importance of routine testing for clostridial infection in patients with diarrhea and risk factors. Such proactive measures could potentially prevent life-threatening complications and reduce hospitalization periods.