Prediction of ComplicatedClostridium difficileInfection by Pleural Effusion and Increased Wall Thickness on Computed Tomography

Abstract

In a selected sample of patients with CDI, CT provided prognostic information additional to what could be obtained from clinical and laboratory parameters. No change in CT characteristics was noted after the introduction of the BI/NAP1/027 strain in our center.

Risk factors for mortality in Clostridium difficile infection in the general hospital population: a systematic review

“…One additional relevant article was found in the hand search of bibliographies, leaving 26 papers in total for the review, including one conference abstract. 11,12 Included studies Characteristics of the studies identified by the literature search are given in Table I. Only two studies were performed outside of the USA, UK or Canada, with the USA accounting for the majority.…”

Efficacy of computed tomography for the prediction of colectomy and mortality in patients with clostridium difficile infection

“…Valiquette et al. [4] found the accordion sign in 56% of their population compared with 4% in the study by Kirkpatrick et al. [2] and 23.5% in our study, making this finding inconstant.…”

“…Peritoneal fluid and pleural effusion were seen in a significantly higher number of our patients (73.5% and 94.1%) than those in the study by Valiquette et al. (56% and 40%, respectively) [4]. We speculate that these differences are due to higher comorbidities in our patients and prolonged hospital stay prior to CDI diagnosis.…”

“…Computed tomography (CT) has shown a sensitivity of 52% and specificity of 93% for the diagnosis of CDI [2], but it is not rutinely used for diagnostic purposes. Several CT findings have been described in association with CDI including wall thickening, pancolitis, low-attenuation mural thickening, the accordion and target sign, pericolonic fat stranding, ascites and most recently, pleural effusion [3], [4]. Moreover, CT parameters have been proposed as predictors of severity and complicated C. difficile colitis.…”

Fidaxomicin in the treatment of colitis due to Clostridium difficile: preliminary results

“…L'infezione "semplice" nel paziente immunocompetente si avvale di una terapia "semplice" con metronidazolo. Le CDI sono però caratterizzate da quadri clinici articolati e differenti [54,60] in rapporto a fattori quali la primitività o meno dell'infezione, le condizioni fisiche e cliniche del paziente, il tipo di ceppo batterico. Ogni paziente quindi presenta una propria sindrome [60][61][62][63][64][65][66][67][68][69] per la quale esiste un trattamento che può consistere in: y modifica e/o reiterazione delle terapie mediche antibatteriche [60][61][62][63][64][65][66][67][68][69]; y immunoglobuline; y trapianto di feci [70,71]; y opzioni chirurgiche [67,68].…”