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Clostridium difficile colitis.

J M Rocca, A S Pieterse, R Rowland

    Australian and New Zealand Journal of Medicine
    |October 1, 1984
    PubMed
    Summary
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    Histological examination of rectal biopsies in patients with Clostridioides difficile infection revealed pseudomembranous colitis in over half of cases. Early diagnostic features were identified in the surface epithelium, aiding in prompt C. difficile colitis diagnosis.

    Area of Science:

    • Gastroenterology
    • Infectious Diseases
    • Histopathology

    Background:

    • Clostridioides difficile infection (CDI) is a significant cause of antibiotic-associated diarrhea.
    • Accurate and timely diagnosis is crucial for effective patient management.
    • Histopathological findings in rectal biopsies can aid in diagnosing CDI.

    Purpose of the Study:

    • To review histological findings in rectal biopsies from patients with proven Clostridioides difficile infection.
    • To correlate histopathological features with clinical presentation and severity.
    • To identify early diagnostic histological markers for C. difficile colitis.

    Main Methods:

    • Retrospective review of 36 rectal biopsies from patients diagnosed with C. difficile infection between 1977 and 1982.

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  • Analysis of histological features including normal, congestion/edema, nonspecific colitis, infective colitis, and pseudomembranous colitis (PMC).
  • Correlation of histological findings with patient symptoms and recent antibiotic treatments (ampicillin, amoxycillin).

    • Main Results:

    • Pseudomembranous colitis (PMC) was observed in 53% of cases.
    • Early PMC features included epithelial attenuation, inflammation, intraepithelial microabscesses, and small eruptive lesions.
    • Poor correlation was noted between histological appearances and symptom severity.

    Conclusions:

    • Histopathology of rectal biopsies is valuable in diagnosing C. difficile infection.
    • Recognition of early epithelial changes in the context of acute colitis can facilitate early diagnosis of C. difficile colitis.
    • Antibiotic history, particularly ampicillin or amoxycillin use, was common among symptomatic patients.