• To the right is an example of what Mr. DA's colonic mucosa looks like.
• In this opened segment of bowel, there is a yellow-green  layer, or pseudomembrane, covering the epithelium.
• Want to see the micro again?
• So what do we do?
• We've got to kill the bug and hope the spores don't take over again.

• Start with a drug with good anaerobic activity: metronidazole (Flagyl)
• If that relapses, go to something like Vancomycin.
• The 'garden variety' of antimicrobial-associated diarrhea, without evidence of pseudomembrane or C. difficile, usually responds to cessation of the antibiotic.
• It's also important to let him know how this happened, so he doesn't pull the same bonehead stunt next month. 

Getting the picture that bugs cause disease in lots of different ways?

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