A patient of Acute lymphocytic leukemia with fever and neutropenia develops diarrhoea after administration of amoxicillin therapy, which of the following organism is most likely to be the causativeagent –
**Core Concept**
The question tests the understanding of antibiotic-associated diarrhea in immunocompromised patients, specifically the overgrowth of opportunistic pathogens in the gut due to disruption of normal flora by broad-spectrum antibiotics.
**Why the Correct Answer is Right**
Amoxicillin, a broad-spectrum beta-lactam antibiotic, can disrupt the normal gut flora, leading to overgrowth of opportunistic pathogens. In immunocompromised patients, such as those with acute lymphocytic leukemia (ALL), the gut is particularly susceptible to colonization by pathogens like Clostridioides difficile (C. difficile). C. difficile produces toxins that cause severe diarrhea and colitis in these patients.
**Why Each Wrong Option is Incorrect**
**Option A:** Not applicable (no option was provided for A)
**Option B:** While other bacteria like E. coli, Klebsiella, or Pseudomonas can cause diarrhea, they are less likely to be the causative agent in this specific scenario.
**Option C:** Other opportunistic pathogens like Candida or Aspergillus can cause diarrhea in immunocompromised patients, but they are not typically associated with antibiotic use.
**Clinical Pearl / High-Yield Fact**
In patients with fever and neutropenia, especially those on broad-spectrum antibiotics, consider empiric treatment for C. difficile infection if diarrhea develops, as it can rapidly progress to severe colitis.
**Correct Answer: C. Clostridioides difficile**