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Contact Precautions:
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Related Experiment Video

Updated: Jun 21, 2026

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Published on: December 8, 2014

Does my patient have Clostridium difficile infection?

Lance R Peterson1, Ari Robicsek

  • 1Northwestern University and NorthShore University HealthSystem, Evanston, Illinois 60201, USA. lancer@northwestern.edu

Annals of Internal Medicine
|August 5, 2009
PubMed
Summary

Accurate diagnosis of Clostridium difficile infection (CDI) is crucial. Avoid common misconceptions about testing frequency and sensitivity to prevent misdiagnosis and improve patient outcomes.

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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
06:51

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Published on: December 10, 2016

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Diagnostics

Background:

  • Clostridium difficile infection (CDI) is increasingly prevalent and virulent, leading to worse patient outcomes.
  • Metronidazole resistance in CDI is rising, complicating treatment options.
  • Accurate and timely diagnosis of CDI is critical for effective patient management.

Purpose of the Study:

  • To identify and address common misconceptions in Clostridium difficile infection diagnosis.
  • To improve diagnostic accuracy by highlighting pitfalls in current testing strategies.
  • To guide clinicians toward more effective diagnostic approaches for CDI.

Main Methods:

  • Analysis of common diagnostic errors related to Clostridium difficile infection.
  • Evaluation of the sensitivity and utility of common CDI diagnostic tests, such as glutamate dehydrogenase (GDH).
  • Review of clinical history elements crucial for accurate CDI diagnosis.

Main Results:

  • Three key misconceptions contribute to CDI misdiagnosis: assuming CDI is possible with <3 loose stools/day, relying solely on sensitive but not specific tests like GDH initially, and repeating insensitive tests.
  • These misconceptions can lead to missed diagnoses due to low test sensitivity or false diagnoses in patients unlikely to have CDI.
  • Clinicians may overlook critical historical factors, contributing to diagnostic errors.

Conclusions:

  • Improving CDI diagnosis requires using tests with higher sensitivity.
  • Reducing the frequency of testing for a single diarrheal episode is recommended.
  • Greater attention to patient history is essential for accurate Clostridium difficile infection diagnosis.