Diagnosis-clostridioides difficile infection

(Ann Intern Med 2018;169:49)

• Only test if symptomatic (diarrhea, s/s of colitis); test liquid stool (unless concern for ileus)

• Stool toxin immunoassay (high Sp) + glutamate dehydrogenase (GDH) (high Se)

• Stool PCR: has ↑ Se, but ⊕ if colonized in absence of active infxn; should not necessarily Rx if ⊕ PCR w/ neg toxin assay (JAMA IM 2015;175;1792)

參考➡️ Overdiagnosis of Clostridium difficile infection in the molecular test era

• Obtain CT abdomen/pelvis if suspect complication (toxic megacolon). Consider flex sig if dx uncertain and/or evidence of no improvement on standard Rx.