C. Diff misdiagnosed as UC?

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Carlow
Regular Member


Date Joined Sep 2007
Total Posts : 113
   Posted 12/27/2007 2:35 PM (GMT -7)   
Hey guys,

I've been prescribed vancomycin by my GI to combat this supposed C. Diff infection that I've been dealing with. After a month on flagyl things were going well until I tried to taper off of it. After two unsuccessful attempts to go back on it I'm waiting on my vancomycin to be shipped in. Problem is, the stool sample I sent in last week didn't reveal toxin-a or b related to a C. Diff infection. The lab was supposed to also do a culture to check for C. Diff as well, but someone mixed up the lab orders and the sample was discarded. My GI says I should take the vancomycin anyway, but I'm hesitant b/c I've read that its the "last resort" drug. Does anyone else think its strange that he would tell me to take this drug without verifiable lab results? I'm tempted to drop off one more sample so they can do the culture asap, so I'd only be on the drug a couple of days if it turns out this is just another relapse of my UC flare. On that note, has anyone every heard of someone being diagnosed with UC, when in fact they had chronic pseudomembranous colitis? Are the lesions similar in a colonoscopy? From what I've read, testing for it can be tricky, especially if just the toxin tests are done to check for the C. Diff.
Diagnosed Fall of 2004

Meds:
Remicade 6 infusions
(Per Day):
ProBio 1
Asacol 8
Canasa 2
Rowasa 1


dakotagirl
Veteran Member


Date Joined Apr 2006
Total Posts : 3402
   Posted 12/27/2007 7:03 PM (GMT -7)   
I think that resorting to vancomycin without a verifiable lab report is dangerous. That's one of the "big" antibiotics and once you go there, who knows what's next. From what I understand, it knocks out your whole immune system. I think your idea of another sample is good. A frank talk with your doc is in order.

I'm not sure about the psuedo... colitis. I do know that UC/Crohn's can be hard to dx and sometimes are misdiagnosed.

Perhaps a second opinion is in order?
Pan-colitis and GERD diagnosed May 2003
 
Asacol 12 per day,  Azathioprine 75mg, Rowasa and Canasa as needed
Aciphex, Effexor XR, BCP, Rhinocort nasal spray
Forvia and a Probiotic
 
Osteopenia (hip and spine) from prednisone use.  Started Azathioprine because I was steroid dependent.
 
Co-Mod for the UC forum
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ks1905
Veteran Member


Date Joined Sep 2005
Total Posts : 4815
   Posted 12/27/2007 9:05 PM (GMT -7)   
Vancomycin worked very well for my C.diff. The stuff is very very expensive.

I think it only takes 1 day for the cultures, possibly two days....what's the rush to put you on it? I don't know if this is accurate or not but I thought that the C.diff test isn't always accurate....it might take a couple of tests before you get a positive for c.diff result back.

ORAL Vancomycin is only released in the large intestines and isn't systemic; IV Vanco is systemic. http://en.wikipedia.org/wiki/Vancomycin#Intravenous_vs_oral_administration

You can read more about treating (with Vanco) Psuedo Colitis http://en.wikipedia.org/wiki/Pseudomembranous_colitis#Treatment (You may want to read the whole web page about psuedomembrane Colitis)

--Keith
DX'd with Pan-Colitis June 2005
Current Status: Flaring since May
 
Current Meds:  50 mgs 6-mp, Colocort, Oral Cyclosporine (500 mgs)
Supplements:  None 
 


Carlow
Regular Member


Date Joined Sep 2007
Total Posts : 113
   Posted 12/27/2007 11:19 PM (GMT -7)   
Thanks guys,

My gut is acting all sorts of wacky these past few days, thus making me more and more committed to having the culture done before taking the vancomycin. Hooray for more stool samples :(.

As for the chronic pseudomembranous colitis (c. diff), I was just curious if anyone had ever head of people being misdiagnosed with UC and then having anti-inflammatory and immunosupressive drugs cover up or suppress the presence of the infection for months or years. <shrug>.
Diagnosed Fall of 2004

Meds:
Remicade 6 infusions
(Per Day):
ProBio 1
Asacol 8
Canasa 2
Rowasa 1


ks1905
Veteran Member


Date Joined Sep 2005
Total Posts : 4815
   Posted 12/28/2007 12:20 AM (GMT -7)   
If you are not satisfied with your Dx or your GI then seek out a professional second opinion.... when I was first dx'd I had a second opinion with another GI.... I was also scheduled for an consultation with one of the top IBD specialists in the Country but ended in the hospital with C.diff and a severe flare before I could see the IBD specialist (which would have been a 3rd opinion).

I would think that your insurance would cover you for a 2nd opinion with another GI.

--Keith
DX'd with Pan-Colitis June 2005
Current Status: Flaring since May
 
Current Meds:  50 mgs 6-mp, Colocort, Oral Cyclosporine (500 mgs)
Supplements:  None 
 


expecting226
Regular Member


Date Joined Jul 2007
Total Posts : 402
   Posted 12/28/2007 6:25 AM (GMT -7)   
I think it depends on how your UC was diagnosed in the first place. If it was diagnosed via biopsies during a colonoscopy, then I don't see how there could be a mistake between UC and C Diff diagnoses.

I agree with ks1905, though. If you are in doubt, get a second opinion!
Current Medications:
- Asacol (4 pills, 3x per day)
- Rowasa (1 enema daily, as needed)
- Folic Acid (1 mg, 1x per day)
- Calcium (600 mg, 2x per day)
- Prenatal Vitamin (1x per day)
- Iron (2x per day)


MitzMN
Veteran Member


Date Joined Feb 2007
Total Posts : 622
   Posted 12/28/2007 8:01 AM (GMT -7)   
I was misdiagnosed with UC when I really had c-diff. I insisted on a c-diff test, though my doctor thought that was certainly not necessary as I was an otherwise healthy adult. I was put on pred and went on vacation, only to get a call that, yes, I was positive for c-diff, so I took Flagyl (and took Flagyl again, and finally got rid of the sucker with Vanco).

I would not at all be surprised that you still have c-diff. It is quite common to get a false negative, but you will never get a false positive. Since Vancomycin is so very expensive, and it is a drug of last resort, I would see how your symptoms are over the next few days to a week and/or insist on a stool test, and if you felt you still had your c-diff, I'd take the vanco. It will probably take care of the c-diff problem.

I was hoping that with this diagnosis, I did not have UC after all. Unfortunately, a year later or so, I was diagnosed with UC and now take Azathioprine every day to treat it (quite successfully, I might add).

Good luck to you!

Mitz
Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri


Carlow
Regular Member


Date Joined Sep 2007
Total Posts : 113
   Posted 12/28/2007 12:04 PM (GMT -7)   
So my GI called this morning, he wants me to bring by another sample so it can be cultured. In the meantime my vanco should be ready this afternoon. I'm tempted just to take it before the test comes back, meh, we'll see. I was up over half the night running to the bathroom for practically nothing...this has happened twice in a week now. I still have a loose/semi-solid bm, its just 5 or 6 times after that I have to go and almost nothing comes out! So frustrating!

I have received a second opinion, although it was just a consult with blood tests, not a c-scope. They went with the UC dx too. Its just that asacol worked wonders for me up until a year and a half ago...then everything went up in flames. Since then, nothing has been able to put me into remission...I mean nothing. I've tried just about everything at this point. Guess I'm desperate for some easy answers eh?
Diagnosed Fall of 2004

Meds:
Remicade 6 infusions
(Per Day):
ProBio 1
Asacol 8
Canasa 2
Rowasa 1

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