22nd July 2023

A 72-year-old woman presents to the emergency department with a 4-day history of severe generalised abdominal pain

A 72-year-old woman presents to the emergency department with a 4-day history of severe generalised abdominal pain associated with loose, pungent non-bloody diarrhoea, passing 8 bowel motions a day. She has a history of gout, GORD, hypertension, venous insufficiency and diet controlled type 2 diabetes. Her regular medications include allopurinol 100mg OD, amlodipine 10mg OD and omeprazole 20mg OD. She is allergic to penicillins. 2 weeks ago she completed a 7-day course of oral clindamycin for a left leg cellulitis. She is extremely tender across the whole of her abdomen, however, there is no guarding or rebound tenderness. She is disorientated to time and place. Whilst awaiting her blood results, she has a CT abdomen and pelvis, which shows a markedly dilated colon with mesenteric oedema and fat stranding.

Which pathogen is most likely to have caused this woman’s presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.