Clostridium difficile infection in patients with unexplained leukocytosis

Wanahita, Anna; Goldsmith, Elizabeth A.; Marino, Bernard; Musher, Daniel M.

doi:10.1016/s0002-9343(03)00420-0

Cited by 93 publications

(51 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In an observational study, leukocytosis was found in 50z of patients with CDI (16). In another study on patients with unexplained leukocytosis, 58z of patinets had CDI (17).…”

mentioning

confidence: 94%

A Superior Test for Diagnosis of Clostridium difficile-Associated Diarrhea in Resource-Limited Settings

et al. 2012

View full text Add to dashboard Cite

SUMMARY:In this prospective cohort study, we investigated the prevalence of Clostridium difficileassociated diarrhea (CDAD) in adult patients with nosocomial diarrhea by performing enzyme immunoassay (EIA) for detecting toxins A and B and polymerase chain reaction (PCR) for detecting the presence of the tcdB gene in stool samples. We determined the factors associated with CDAD, and the treatment outcome of CDAD from May 2010 to January 2011. A total of 175 stool samples were tested by EIA and PCR. In total, 26.9z patients tested positive for C. difficile: 12.6z by EIA and 24.0z by PCR. The kappa coefficient and total agreement of both the tests were 0.46 and 83.2z, respectively. Onset of diarrhea after antibiotic administration for 10 days or more (OR, 2.71; 95z CI, 1.14-6.44; P ＝ 0.024) and leukocyte count À15,000 cells/mm 3 (OR, 3.12; 95z CI, 1.24-7.88; P ＝ 0.016) were significantly associated with occurrence of CDAD. The non-response rate to CDAD treatment was 24.1z, and the all-cause mortality rate was 31.9z in the CDAD group as against 35.9z in the non-CDAD group (P ＝ 0.721). In our study, the performance of direct PCR of stool samples for detecting tcdB was better, with the number of positive results for stool toxins A and B being twofold higher than that in the case of EIA. Patients who have diarrhea after receiving antibiotics for 10 days or more or those who have a leukocyte count of À15,000 cells/mm 3 should be investigated for CDAD.

show abstract

“…In an observational study, leukocytosis was found in 50z of patients with CDI (16). In another study on patients with unexplained leukocytosis, 58z of patinets had CDI (17).…”

mentioning

confidence: 94%

A Superior Test for Diagnosis of Clostridium difficile-Associated Diarrhea in Resource-Limited Settings

et al. 2012

View full text Add to dashboard Cite

show abstract

“…A previous study concluded that infection with C difficile should be considered in hospitalized patients with leukocytosis preceding, coinciding or worsening with diarrhoea who were previously or concurrently treated with antibiotics (13). Another study found that most patients with unexplained leukocytosis had C difficile infection as compared with controls in a tertiary care hospital setting (14). In a third report, leukocytosis and a high creatinine level were strong and independent factors associated with an increased risk of complicated CDI (8).…”

Section: Resultsmentioning

confidence: 99%

A Review of Clostridium difficile Infection at the University Hospital of the West Indies, Jamaica

Clare-Pascoe¹,

Mg²,

Murphy³

et al. 2015

West Indian Med J

View full text Add to dashboard Cite

“…In fact, for all patients without a hematologic malignancy who had a WBC > 30000/mm 3 , 25% were found to have CDI [34] . The elevation of WBC may even precede the onset of diarrhea or abdominal discomfort [35] and may be responsible for up to 58% of cases of unexplained leukocytosis in hospitalized patients [36] . In a series of patient with leukocytosis who were C. difficile toxin negative, empiric treatment for CDI led to resolution of leukocytosis [36] .…”

Section: Clinical Presentation Of CDImentioning

confidence: 99%

“…The elevation of WBC may even precede the onset of diarrhea or abdominal discomfort [35] and may be responsible for up to 58% of cases of unexplained leukocytosis in hospitalized patients [36] . In a series of patient with leukocytosis who were C. difficile toxin negative, empiric treatment for CDI led to resolution of leukocytosis [36] . CDI results in a protein losing enteropathy with resultant hypoalbuminemia [37] .…”

Section: Clinical Presentation Of CDImentioning

confidence: 99%

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Oldfield

Johnson

2014

WJGPT

View full text Add to dashboard Cite

Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospitalacquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

show abstract

Clostridium difficile infection in patients with unexplained leukocytosis

Cited by 93 publications

References 18 publications

A Superior Test for Diagnosis of Clostridium difficile-Associated Diarrhea in Resource-Limited Settings

A Superior Test for Diagnosis of Clostridium difficile-Associated Diarrhea in Resource-Limited Settings

A Review of Clostridium difficile Infection at the University Hospital of the West Indies, Jamaica

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Contact Info

Product

Resources

About