Diagnosis of Clostridium difficile Colitis
Authors: Joseph M. Vinetz
Journal: Annals of Internal Medicine (1996)

Letters15 September 1996Diagnosis of Clostridium difficile ColitisJoseph M. Vinetz, MD, Yukari Manabe, MD, and John G. Bartlett, MDJoseph M. Vinetz, MDJohns Hopkins University School of Medicine, Baltimore, MD 21205Search for more papers by this author, Yukari Manabe, MDJohns Hopkins University School of Medicine, Baltimore, MD 21205Search for more papers by this author, and John G. Bartlett, MDJohns Hopkins University School of Medicine, Baltimore, MD 21205Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-6-199609150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Nardone that clinicians use patterns of clinical and laboratory variables to solve problems. We have analyzed the manner in which the sequential addition of our identified predictors affected the diagnosis of C. difficile disease (Table 2). Although this information may be useful, the results are not statistically significant. For practical purposes, physicians will suspect C. difficile-associated enteric complications in any patient with otherwise unexplained diarrhea that occurs with exposure to antibiotics. Decisions about use of laboratory testing are optimally dictated by the effect of the test results on management and by the probability of ...References1. Hirschhorn LR, Trnka Y, Onderdonk, Lee ML, Platt R. Epidemiology of community-acquired Clostridium difficile-associated diarrhea. J Infect Dis. 1994; 169:127-33. Google Scholar2. Anand A, Bashey B, Mir T, Glatt AE. Epidemiology, clinical manifestations, and outcome of Clostridium difficile-associated diarrhea. Am J Gastroenterol. 1994; 89:519-23. Google Scholar3. Merz CS, Kramer C, Forman M, Gluck L, Mills K, Senft K, et al. Comparison of four commercially available rapid enzyme immunoassays with cytotoxin assay for detection of Clostridium difficile toxin(s) from stool specimens. J Clin Microbiol. 1994; 32:1142-7. Google Scholar4. Laughon BE, Viscidi RP, Gdovin SL, Yolken RH, Bartlett JG. Enzyme immunoassays for detection of Clostridium toxins A and B in fecal specimens. J Infect Dis. 1984; 149:781-8. Google Scholar5. McFarland LV, Mulligan ME, Kwok MS, Stamm WE. Nosocomial acquisition of Clostridium difficile-associated infection. N Engl J Med. 1989; 320:204-10. Google Scholar Author, Article, and Disclosure InformationAuthors: Joseph M. Vinetz, MD; Yukari Manabe, MD; John G. Bartlett, MDAffiliations: Johns Hopkins University School of Medicine, Baltimore, MD 21205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntibiotic-Associated Colitis 15 September 1996Volume 125, Issue 6 Page: 516 Keywords Antibiotics Clindamycin Clinical laboratories Diarrhea Research laboratories Salmonella Shigella Specificity Toxins Vibrio cholerae ePublished: 15 August 2000 Issue Published: 15 September 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...