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Tests and diagnosis
By Mayo Clinic staffDoctors often suspect C. difficile in anyone with diarrhea who has taken antibiotics during the past two months or when diarrhea develops a few days after hospitalization. In such cases, you're likely to have one or more of the following tests:
- Stool tests. Toxins produced by C. difficile bacteria can usually be detected in a sample of your stool. There are several main types of lab tests (enzyme immunoassay, polymerase chain reaction and tissue culture assay). Most labs use the enzyme immunoassay (EIA) test, which is faster but can produce a false-positive result. Some hospitals use both the EIA test and tissue culture assay to ensure accurate results.
- Colon examination. In some cases, to help confirm a diagnosis of C. difficile infection, your doctor may examine the inside of your colon. This test (flexible sigmoidoscopy) involves inserting a flexible tube with a small camera on one end into your lower colon to look for areas of inflammation and pseudomembranes.
- Imaging tests. If there's concern about possible complications of C. difficile, your doctor may order a computerized tomography (CT) scan, which provides detailed images of your colon. The scan can show a thickening of the wall of your colon, which is common in pseudomembranous colitis.
References
- Kelly CP, et al. Treatment of antibiotic-associated diarrhea caused by Clostridium difficile in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2010.
- Bartlett JG. Narrative review: The new epidemic of Clostridium difficile-associated enteric disease. Annals of Internal Medicine. 2006;145:758.
- Pepin J, et al. Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: A changing pattern of disease severity. Canadian Medical Association Journal. 2004;171:466.
- Kelly CP, et al. Clostridium difficile — More difficult than ever. New England Journal of Medicine. 2008;359:1932.
- LaMont JT. Clinical manifestations and diagnosis of Clostridium difficile infection in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2010.
- Efron PA, et al. Clostridium difficile colitis. Surgical Clinics of North America. 2009;89:483.
- Monaghan T, et al. Recent advances in Clostridium difficile-associated disease. Gut. 2008;57:850.
- Kelly CP, et al. Antibiotic-associated diarrhea, pseudomembranous enterocolitis, and Clostridium difficile-associated diarrhea and colitis. In: Feldman M, et al. Sleisenger and Fordtan's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-1-4160-6189-2&eid=4-u1.0-B978-1-4160-6189-2..00108-6. Accessed Sept. 30, 2010.
- Bartlett JG, et al. Clinical recognition and diagnosis of Clostridium difficile infection. Clinical Infectious Diseases. 2008;46(suppl):S12.
- Bakken JS. Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe. 2009;15:285.
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