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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. Patient information: Antibiotic-associated diarrhea (Clostridium difficile). http://www.uptodate.com. Accessed Nov. 3, 2008.
- Bartlett JG. Narrative review: The new epidemic of Clostridium difficile-associated enteric disease. Annals of Internal Medicine. 2006;145:758.
- Kelly CP, et al. Treatment of antibiotic-associated diarrhea caused by Clostridium difficile. http://www.uptodate.com. Accessed Nov. 3, 2008.
- 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. http://www.uptodate.com. Accessed Nov. 3, 2008.
- Durai R. Epidemiology, pathogenesis, and management of Clostridium difficile infection. Digestive Disease Science. 2007;52:2958.
- Monaghan T, et al. Recent advances in Clostridium difficile-associated disease. Gut. 2008;57:850.
- Sunenshine R, et al. Clostridium difficile-associated disease: New challenges from an established pathogen. Cleveland Clinic Journal of Medicine. 2006;73:187.
- Information for healthcare providers. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html. Accessed March 2, 2009.
- Centers for Disease Control and Prevention, et al. Guideline for hand hygiene in health-care settings. MMWR Recommendations and Reports. 2002;51:RR-16. http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf. Accessed March 2, 2009.
