Clinical recognition and diagnosis of Clostridium difficile infection

John Bartlett, Dale N. Gerding

Research output: Contribution to journalArticle

Abstract

Prompt and precise diagnosis is an important aspect of effective management of Clostridium difficile infection (CDI). CDI causes 15%-25% of all cases of antibiotic-associated diarrhea, the severity of which ranges from mild diarrhea to fulminant pseudomembranous colitis. Several factors, especially advanced age and hospitalization, should be considered in the diagnosis of CDI. In particular, nosocomial diarrhea arising >72 hours after admission among patients receiving antibiotics is highly likely to have resulted from CDI. Testing of stool for the presence of C. difficile toxin confirms the diagnosis of CDI. However, performance of an enzyme immunoassay is the usual method by which CDI is confirmed, but this test appears to be relatively insensitive, compared with the cell cytotoxicity assay and stool culture for toxigenic C. difficile on selective medium. Endoscopy and computed tomography are less sensitive than stool toxin assays but may be useful when immediate results are important or other confounding conditions rank high in the differential diagnosis. Often overlooked aspects of this diagnosis are high white blood cell counts (which are sometimes in the leukemoid range) and hypoalbuminemia.

Original languageEnglish (US)
JournalClinical Infectious Diseases
Volume46
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 15 2008

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Clostridium Infections
Clostridium difficile
Diarrhea
Anti-Bacterial Agents
Pseudomembranous Enterocolitis
Hypoalbuminemia
Patient Admission
Immunoenzyme Techniques
Leukocyte Count
Endoscopy
Hospitalization
Differential Diagnosis
Tomography

ASJC Scopus subject areas

  • Immunology
  • Medicine(all)

Cite this

Clinical recognition and diagnosis of Clostridium difficile infection. / Bartlett, John; Gerding, Dale N.

In: Clinical Infectious Diseases, Vol. 46, No. SUPPL. 1, 15.01.2008.

Research output: Contribution to journalArticle

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