| Theme | Cytomegalovirus enterocolitis and Clostridium difficile infection | |
|---|---|---|
| Title | Pathogenic mechanisms and diagnosis of Clostridium difficile infection | |
| Publish Date | 2015/11 | |
| Author | Hiroyuki Kobayashi | Institute of Gastroenterology, Fukuoka Sanno Hospital |
| [ Summary ] | Clostridium difficile (CD) infection is a typical nosocomial infectious disease. However, not all infected persons develop CD colitis. Toxigenic CD strains produce the toxin (toxin A, B) that causes clinical symptoms. Recently, the third toxin (binary toxin)-positive CD strains have been reported to cause outbreaks and severe CD infection in Europe and America. The clinical characteristics of CD colitis range from mild diarrhea to colitis, to pseudomembranous colitis, or to severe diseases such as toxic megacolon. Although the accurate diagnosis of CD colitis requires evidence of toxins in the patient's stool, the sensitivity of the toxin A+B testing kit is low. Thus, step algorithms combined with the glutamate dehydrogenase antigen test, which is also used with the toxin A+B test, are useful. In addition, sigmoidoscopy is useful for the evaluation of severity of CD colitis such as pseudomembranous colitis. |
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