Medline ® Abstracts for References 101,102
of 'Clostridium difficile infection in adults: Clinical manifestations and diagnosis'
Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease.
LaMont JT, Trnka YM
Clostridium difficile toxin was present in the stools of six patients with chronic inflammatory bowel disease during symptomatic relapse. Only two of these individuals had received antibiotics known to cause pseudomembranous colitis, and on proctoscopy none had pseudomembranes. In all patients disappearance of toxin, either with vancomycin therapy (five patients) or spontaneously (one patient), was associated with symptomatic improvement. Cl. difficile toxin may complicate chronic inflammatory bowel disease, and contribute to relapse in some patients.
Clostridium difficile and inflammatory bowel disease.
Greenfield C, Aguilar Ramirez JR, Pounder RE, Williams T, Danvers M, Marper SR, Noone P
Stools from 109 patients with inflammatory bowel disease (13.4%) contained Clostridium difficile or its toxin, an incidence similar to the stools of 99 control patients with diarrhoea (11.9%), but significantly higher than the stools of 77 control patients with a normal bowel habit (1.4%). Sixty-six per cent of the diarrhoea controls, but only 11% of the inflammatory bowel disease patients, reported recent antibiotic use: however, 67% of inflammatory bowel disease patients were taking sulphasalazine. The presence of Cl difficile in the stool was not related to the clinical assessment of inflammatory bowel disease relapse, but it was related to hospital admission. During the one year study, 31 of the 109 patients (28%) with inflammatory bowel disease had one or more stool samples that were positive for Cl difficile.