Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhea
  • abdominal pain

Other diagnostic factors

  • fever
  • abdominal tenderness
  • nausea and vomiting
  • abdominal distension
  • symptoms of shock

Risk factors

  • antibiotic exposure
  • advanced age
  • hospitalization or residence in a nursing home
  • history of Clostridium difficile-associated disease
  • severe underlying illness
  • immunosuppressive agents or chemotherapy
  • use of a proton-pump inhibitor
  • gastrointestinal surgery
  • inflammatory bowel disease

Diagnostic investigations

1st investigations to order

  • CBC
  • stool guaiac (fecal occult blood test)
  • stool immunoassay for glutamate dehydrogenase
  • stool immunoassay for toxins A and B
  • stool PCR
  • abdominal x-ray
Full details

Investigations to consider

  • stool cytotoxin tissue culture
  • abdominal CT scan
  • sigmoidoscopy or colonoscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Associate Professor of Medicine

Alabama Infectious Diseases Center

Huntsville

AL

Disclosures

AH declares that he has no competing interests.

Peer reviewers VIEW ALL

Department of Epidemiology

Division of General Medicine and Epidemiology

UNC at Chapel Hill

Chapel Hill

NC

Disclosures

JA declares that he has no competing interests.

Consultant Gastroenterologist

Department of Gastroenterology

John Radcliffe Hospital

Oxford

UK

Disclosures

SK declares that he has no competing interests.

Clinical Reader and Consultant Gastroenterologist

Norfolk and Norwich University Hospital

Norwich

UK

Disclosures

IB declares that he has no competing interests.

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