C diff from antibiotics following surgical tooth extraction

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DrPoo
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Joined: Fri Mar 13, 2015 11:22 pm

C diff from antibiotics following surgical tooth extraction

Postby DrPoo » Sat Mar 14, 2015 12:37 am

On August 26, 2014 I had a surgical extraction of a tooth that internally resorbed itself, and was given clindamycin as a prophylactic antibiotic.

On September 25, 2014 I experienced the first symptoms of c-diff: stools which were entirely mucus sandwiched between days of regular stools. Those increased gradually in intensity and frequency, and eventually looked more like pus than mucus - and had a foul smell I now recognize as c-diff. (I have occasionally gotten a piece of meat trapped between my teeth overnight which begins to rot before I discover it and remove it - c-diff smells like that tastes.) The stools also increasingly included bright red blood.

I went to my GP in late October. He ordered a colonoscopy, because the symptoms were much more consistent with IBD or some sort of inflammatory process than with c-diff. I never had anything recognizable as classic diarrhea - for the entire 6 months I have been living with c-diff, all of my stools which were fecal matter, rather than mucus, were solid. By the time I saw my GP, I was having cyclic bouts of mucus for a couple of days, followed by 3-5 days of solid mucus coated stools (with the mucus including bright red blood).

I had a colonoscopy in early November which was absolutely clean. No visible inflammation. Nothing to biopsy. And before I started having stools following the colonoscopy I started expelling mucus.

The GI doc ordered numerous blood tests, and on 11/16/2014 I was diagnosed with c-diff and put on flagyl (250 mg qid) for 10 days (after nearly 2 months of symptoms).

The symptoms decreased fairly quickly (~3 days), but the heavy mucus coating never vanished. Three days after I finished the flagyl, the stools had returned to worse than the worst day pre-flagyl (more than 20 mucus only stools in a 12 hour period, followed by 3-5 days of solid mucus coated stools).

On 12/4/2014 I was told I tested negative for c-diff. My strong suspicion, given what I now know about stool consistency and testing,is that they were unable to test it - rather than the test itself being negative. I have never seen a copy of this test - the results were relayed to me by a doctor whose office was challenging to communicate with. I was put on 14 days of vancomycin (125 mg qid). The symptoms vanished entirely in 3 days on vanco, aside from a very slight mucus cycle that matched the timing of the cycle when it is active. The mucus is only apparent when I squeeze a bit of bm between 2 pieces of toilet paper, separate the paper, and the mucus string extends between the two pieces of TP. The only other remaining symptom is a tiny puff of gas nearly every time I sit down on toilet - which I have never had before.

On 1/6/2015 (19 days after the end of vancomycin), the symptoms returned - and once again were full blown within 3 days. I contacted my daughter's infectious disease doc (more on that later), and asked him to take over my care.

1/15/2015 I saw the infectious disease doc. His assessment of the sample I brought with me was that it looked more like IBD - although it might be IBS following c-diff. He tested the sample, assuming it would be negative and he would be sending me off to my daughter's gastroenterologist for more IBD-like exploration.

1/15/2015 the test came back positive. I was put on Dificid 200 mg bid for 10 days. The symptoms mostly vanished by day 3, although a bit more of the lingering mucus cycle than on vancomycin. I predicted I would get a week to 10 days relief once the meds ended. I got 12 days of relief before it was back again.

On 2/12/2015 in the evening I started on vancomycin, including a trailing pulse/taper.

On 2/13/2015 I was able to collect a testable sample before the vancomycin kicked in, which tested positive on 2/15/2015. (I can only collect testable samples during the portion of the cycle which produces mucus stools, because the fecal matter stools are too solid to test.) As in the past, within 3 days I was back to virtually no symptoms.

I am currently in the 7-day, every other day portion of the taper. So far so good. No gross symptoms yet - only very subtle ones I would not notice except that I am paranoid about looking for them. I go back and forth between cautious optimism because the cyclical nature of my symptoms matches the pulsing strategy in a way I think might be useful - and terror when I realize I can still detect the cyclical mucus pattern if I look hard enough for it.

As to my daughter: She has had c-diff in the past, secondary to ulcerative colitis - hence the background knowledge I have about c-diff, and the ready access to specialists. She hides from her body's symptoms because it hurts too much (emotionally) to pay attention - but off and on she is afraid that she also has c-diff.

It is also almost certain that I transmitted c-diff to my father. We were together in the first few days I was on flagyl - during which time he was on clindamycin (we share a penicilllin allergy). He was trying to head off an infection that ultimately led to a root canal. He did have c-diff by December, and his symptoms were virtually identical to mine (symptoms unusual enough for c diff that the original GP, the gastroenterologist, and infectious disease specialist were each certain it was not c-diff).

If I relapse again, I will be sent to my daughter's gastroenterologist for evaluation for FMT. And my daughter will kill me because she has been actively (unsuccessfully) looking for a trial that will allow her to have one for her UC - so me having one before her, through her gastroenterologist, will not go over well.

So - if I'm not dead, I'll post an update in a month or so when I see how things go when I'm entirely off the vanco (assuming symptoms don't return before then).

DrPoo
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Posts: 15
Joined: Fri Mar 13, 2015 11:22 pm

Re: C diff from antibiotics following surgical tooth extract

Postby DrPoo » Wed Apr 01, 2015 12:34 am

Well shucky darn.

I hope I'm wrong, but 3 more days to go on my vanco taper I'm afraid it's back.

My recurrences always start off with a stool that is exclusively mucus. Late afternoon I got the feeling one was making its way through my system - and sure enough I was right. I did have a 24 hour GI bug of some sort over the weekend - I'm hoping this was just a leftover from the weekend (even though it was nothing like the weekend "visitor")

DrPoo
New User
Posts: 15
Joined: Fri Mar 13, 2015 11:22 pm

Re: C diff from antibiotics following surgical tooth extraction - long overdue update

Postby DrPoo » Fri Apr 10, 2020 2:12 pm

Long overdue update! A friend of mine whose son has encountered c. diff reminded me of this site - and I see I left off with a cliffhanger.

The symptoms were just paranoia. It did not return . . . then. But I've had mild bouts approximately once a year since then (the last perhaps 6 months ago).

I have found that s. bouliardii is remarkably effective against my particular strain of c diff. I try to keep Jarrow's brand around (it is about 20% of the price of Florastor and works wonders for me). At the first symptoms - or anytime I am on antibiotics - I start taking 4 capsules a day (split two in the morning, two in the afternoon). (I'm not positive of the dose - since I need it about once a year I usually recalculate it based on research reports of the effective dose.) If it is in response to symptoms, they usually disappear within 48 hours. I haven't had any flare-ups in response to taking antibiotics.

For a while, I had my infectious disease doc on speed-dial - and called to set up a test "just in case." By now, I don't even bother to call him. I just start with s. bouliardii.


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