Last reviewed:October 2019
Last updated:September  2018

Summary

Definition

History and exam

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
  • use of acid-suppressing drugs
  • inflammatory bowel disease
  • solid organ transplant recipients
  • hematopoietic stem cell transplant recipients
  • chronic kidney disease
  • HIV infection
  • immunosuppressive agents or chemotherapy
  • gastrointestinal surgery

Diagnostic investigations

1st investigations to order

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

Investigations to consider

  • cell culture cytotoxicity neutralization assay
  • CT abdomen
  • sigmoidoscopy or colonoscopy
Full details

Emerging tests

  • stool lactoferrin or calprotectin
Full details

Treatment algorithm

Contributors

Clinical Associate Professor of Medicine

Alabama Infectious Diseases Center

Huntsville

AL

Disclosures

AH declares that he has no competing interests.

Peer reviewersVIEW 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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