PMC7737437_01
Abdomen X-ray showing thumbprinting sign.
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fig1
The abdominal X-ray (Figure 1) demonstrated a classical thumbprinting sign that was nonspecific but suspicious for clostridium difficile infection.
Distal sigmoid colon showing severe colitis.
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fig2
When the patient did not respond to IV metronidazole and oral vancomycin, a flexible sigmoidoscopy was undertaken and showed nodular mucosa with white-yellowish adherent plaques with increasing severity from the rectosigmoid to the sigmoid (Figures 2 and 3).
Midsigmoid colon showing extension of the severe colitis to the midsigmoid region.
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fig3
When the patient did not respond to IV metronidazole and oral vancomycin, a flexible sigmoidoscopy was undertaken and showed nodular mucosa with white-yellowish adherent plaques with increasing severity from the rectosigmoid to the sigmoid (Figures 2 and 3).