Case Study

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16 Jul 2016 - General

72 years old gentleman, with background of chronic obstructive pulmonary disease with recurrent admission due to infective exacerbation of chronic obstructive pulmonary disease (last exacerbation 3 months ago), type 2 diabetes, hypertension, ischeamic heart disease (with 2 previous stent),  recent clostridium difficile infection/diarrhoea 4 weeks ago, was admitted to hospital due to worsening diarrhoea for the last week, with the frequency of loose waterry stool up to 5-6 times per day, associated with abdominal discomfort. On examination, abdomen is soft, but general mild tenderness. PR examination was normal with normal FOB. PFA was normal. Blood result showed slightly elevated CRP , and ESR.  Stool sample was sent as well. What would be your working diagnosis for this patient ??? What can be the potential differential diagnosis ? What managment plan would you seggest ??