Colonic disease associated with a positive assay for Clostridium difficile toxin: a retrospective study
Nash, S.V.; Bourgeault, R.; Sands, M.
Journal of Clinical Gastroenterology 25(2): 476-479
1997
ISSN/ISBN: 0192-0790 PMID: 9412955 Document Number: 479896
In this retrospective review of colonic tissue from 21 patients with a positive stool assay for Clostridium difficile toxin, four groups of patients were identified by pathologic examination. Classic pseudomembranous colitis was identified in 38% of patients in colon biopsies, resections, and at postmortem examination. One third of patients had acute colitis without specific features on colon biopsies at the time of a positive toxin assay. Effects of C. difficile toxin in patients with idiopathic inflammatory bowel disease (10%) could not be pathologically separated from activity of the underlying disease. In 19% of patients, no acute or chronic colitis or pseudomembranous colitis was noted. This report reminds gastroenterologists that C. difficile infection is associated with a range of pathologic changes similar to the well known clinical spectrum of disease.