Last reviewed: 3 Feb 2021
Last updated: 06 May 2020
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
- vitamin D deficiency
Diagnostic investigations
1st investigations to order
- CBC
- stool guaiac (fecal occult blood test)
- stool polymerase chain reaction (PCR)
- stool immunoassay for glutamate dehydrogenase
- stool immunoassay for toxins A and B
- abdominal x-ray
Investigations to consider
- cell culture cytotoxicity neutralization assay
- CT abdomen
- sigmoidoscopy or colonoscopy
Treatment algorithm
Contributors
Authors
Clinical Associate Professor of Medicine
Alabama Infectious Diseases Center
Huntsville
AL
Disclosures
AH declares that he has no competing interests.
Peer reviewers
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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