Sandbox/00030

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[UNDER CONSTRUCTION]


C. difficile Infection Microchapters

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Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Classification

Differentiating Clostridium difficile infectionfrom other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

Abdominal CT Scan

Other Imaging Findings

Biopsy

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

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Medical Therapy

Principles of Therapy

  • If a patient has a strong pre-test suspicion for CDI, empiric therapy for CDI should be considered regardless of the laboratory testing result.
  • Clostridium difficile infection should be suspected in any patient with diarrhea who has received antibiotics within the previous 2 months and/or whose diarrhea began 72 hours or more after hospitalization.[1]

Classification of Disease Severity

Severity Definition
Mild CDI with diarrhea as the only symptom.
Moderate CDI with diarrhea but without additional symptoms/signs meeting the definition of severe or complicated CDI.
Severe CDI that presents with or develops during the course of the disease with hypoalbuminemia (serum albumin < 3 g/dl) and either of the following:
  • A white blood cell (WBC) count ≥15,000 cells/mm3
  • Abdominal tenderness
Complicated CDI that presents with or develops at least one of the following signs or symptoms:
  • Admission to intensive care unit
  • Hypotension with or without required use of vasopressors
  • Fever ≥38.5°C
  • Ileus or significant abdominal distention
  • Mental status changes
  • WBC ≥35,000 cells/mm3 or <2,000 cells/mm3
  • Serum lactate levels >2.2 mmol/l
  • Any evidence of end organ failure

References