Value of Clostridium difficile antigen test in immunocompromised hosts in the tropics

39 fecal and body fluid specimens of immunocompromised patients who developed diarrhoea were tested for Clostridium difficile antigen test. The test was identified in only 11 and in one ascitic fluid. Endoscopy was performed in 5 patients and it showed pseudomembranous colitis in one. Numerous antibiotics were associated with C. difficile related diarrhea: ampicillin, 43%; cephalosporins, 43% and clindamycin, 14%. Three Salmonella sp., and one Entamoeba histolytica were detected among patients who later developed C. difficile associated diarrhea. The effect of oral vancomycin and fusidic acid was demonstrated in patients with C. difficile related diarrhea or colitis. The C. difficile antigen test is promising diagnostic tool in immunocompromised hosts in the tropics where both Salmonella and E. histolytica all are endemic.