Difficulties in diagnosing and managing a patient with the onset of ulcerative colitis and Clostridium difficile associated disease

Currently, Clostridium difficile associated infection (CDI) is the leading cause of nosocomial diarrhea, the incidence of which has a steady upward trend. Higher incidence and severity of CDI have been reported in patients with inflammatory bowel disease. The defeat of the immune system, the similarity of a number of clinical symptoms, the difficulty of choosing adequate therapy make it difficult to manage such patients. The clinical case of the debut of ulcerative colitis in combination with CDI presented in the article shows the difficulty of differential diagnosis of these diseases. The prevalence and severity of the inflammatory process in the patient were due to a combination of two etiological factors — CDI and autoimmune damage to the colon mucosa. Timely diagnosis of CDI enabled optimal treatment, resulting in remission of ulcerative colitis and the elimination of Clostridium difficile associated infection.