Sandbox/00030: Difference between revisions
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'''[UNDER CONSTRUCTION]''' | |||
{{Clostridium difficile infection}} | |||
==Medical Therapy== | |||
====Principles of Therapy==== | |||
* If a patient has strong a pre-test suspicion for CDI, empiric therapy for CDI should be considered regardless of the laboratory testing result, as the negative predictive values for CDI are insufficiently high to exclude disease in these patients. | |||
:* ''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.<ref name="pmid9149180">Fekety R (1997) [http://www.ncbi.nlm.nih.gov/pubmed/9149180 Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. American College of Gastroenterology, Practice Parameters Committee.] ''Am J Gastroenterol'' 92 (5):739-50. PMID: [http://www.ncbi.nlm.nih.gov/pubmed/9149180]</ref> | |||
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! style="background: #DCDCDC;" | Definition | ! style="background: #DCDCDC;" | Definition | ||
|- | |- | ||
! style="background: #F5F5F5; padding: 10px 10px;" | Mild | ! style="background: #F5F5F5; padding: 10px 10px;" | Mild | ||
| style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI with diarrhea as the only symptom. | | style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI with diarrhea as the only symptom. | ||
|- | |- | ||
! style="background: #F5F5F5; padding: 10px 10px;" | Moderate | ! style="background: #F5F5F5; padding: 10px 10px;" | Moderate | ||
| style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI with diarrhea but without additional symptoms/signs meeting the definition of severe or complicated CDI. | | style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI with diarrhea but without additional symptoms/signs meeting the definition of severe or complicated CDI. | ||
|- | |- | ||
! style="background: #F5F5F5; padding: 10px 10px;" | Severe | ! style="background: #F5F5F5; padding: 10px 10px;" | Severe | ||
| style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI that presents with or develops during the course of the disease with hypoalbuminemia (serum albumin < 3 g/dl) '''<u>and</u>''' either of the following: | | style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI that presents with or develops during the course of the disease with hypoalbuminemia (serum albumin < 3 g/dl) '''<u>and</u>''' either of the following: | ||
* A white blood cell (WBC) count ≥15,000 cells/mm<sup>3</sup> | * A white blood cell (WBC) count ≥15,000 cells/mm<sup>3</sup> | ||
* Abdominal tenderness without criteria of complicated disease | * Abdominal tenderness without criteria of complicated disease | ||
|- | |- | ||
! style="background: #F5F5F5; padding: 10px 10px;" | Complicated | ! style="background: #F5F5F5; padding: 10px 10px;" | Complicated | ||
| style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI that presents with or develops at least one of the following signs or symptoms: | | style="background: #F5F5F5; padding: 10px 10px;" valign=top | CDI that presents with or develops at least one of the following signs or symptoms: | ||
* Admission to intensive care unit | * Admission to intensive care unit | ||
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* Any evidence of end organ failure | * Any evidence of end organ failure | ||
|} | |} | ||
==References== | |||
{{reflist|2}} | |||
Revision as of 01:14, 5 June 2014
[UNDER CONSTRUCTION]
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C. difficile Infection Microchapters |
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Differentiating Clostridium difficile infectionfrom other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Sandbox/00030 On the Web |
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American Roentgen Ray Society Images of Sandbox/00030 |
Medical Therapy
Principles of Therapy
- If a patient has strong a pre-test suspicion for CDI, empiric therapy for CDI should be considered regardless of the laboratory testing result, as the negative predictive values for CDI are insufficiently high to exclude disease in these patients.
- 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:
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| Complicated | CDI that presents with or develops at least one of the following signs or symptoms:
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References
- ↑ Fekety R (1997) Guidelines for the diagnosis and management of Clostridium difficile-associated diarrhea and colitis. American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 92 (5):739-50. PMID: [1]