Sandbox/00030

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[UNDER CONSTRUCTION]


C. difficile Infection Microchapters

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Differentiating Clostridium difficile infectionfrom other Diseases

Epidemiology and Demographics

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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