Clostridium Difficile – Part 3
The clinical presentation of C diff colitis can range from constipation to a few mild episodes of diarrhea to fulminant pseudomembranous colitis. The most typical presentation is voluminous, foul-smelling, nonbloody diarrhea with abdominal cramps, abdominal tenderness, fever, and elevated white blood cell count on laboratory tests.
Most experienced clinicians will treat based on clinical suspicion. The most readily available laboratory test is testing of a stool sample for Clostridium difficile toxin A using an ELISA test (enzyme-linked immunosorbent assay technique). This gives an accuracy rate of about 80% – 90%. A tissue culture assay for the presence of C. diff toxin B is the gold standard but is generally less available due to expense. Generally, repeat stool testing with the same assay does not increase accuracy of the C. difficile test.
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