Ulcerative colitis is a type of inflammatory bowel disease (IBD) that affects the large intestine, or colon. It is an ongoing condition that can be unpredictable and cause periods of relapse and remission. Ulcerative colitis produces inflammation in the lining of the rectum and colon, resulting in painful ulcers, abdominal cramps, diarrhea, and more.
The exact cause of ulcerative colitis is unknown but it’s believed to be caused by a combination of environmental factors and genetics. It may also be triggered by an autoimmune reaction where your body mistakenly attacks its own cells in the digestive system. People with close relatives such as parents or siblings who have IBD are at higher risk for developing this condition themselves.
Now place yourself into this OSCE station as you help this patient ulcerative colitis. Test your knowledge below.
A 25 year old male with ulcerative colitis develops a rash on the front of his shin. His GP gives him a course of flucloxacillin as a treatment for cellulitis.
He is allergic to macrolide antibiotics.
Is this a reasonable choice as a treatment for cellulitis?
The patient has now Grown MRSA.
With regards the following statement:
The reason that the MRSA is not treated by the flucloxacillin is that the organism is gram negative unlike normal staphylococci which are gram positive
Despite receiving inpatient treatment for 11 weeks the area previously thought to be cellulitis has ulcerated and remained ulcerated for the previous 9 weeks. Given these findings it raises concerns about the possibility of …
- Fungal infection
- Protazoal infection
- Pyoderma Gangrenosum
- Livedo reticularis
- Bullous Pemphigoid
The swab of the ulcer comes back with the following result.
“The swab has grown staphylococcus aureus. This is a methicillin resistant strain.”
What is the most appropriate course of action to take?
- Continue on flucloxacillin orally
- Switch to flucloxacillin IV
The chance of any person of being colonised with MRSA in the community is:
- 1 in 30 000
- 1 in 3 000
- 1 in 300
- 1 in 30
- 1 in 3