Fulminant Clostridium difficile: an underappreciated and increasing cause of death and complications

Annals of Surgery
Ramsey M DallalRichard L Simmons

Abstract

To review the epidemiology and characteristics of patients who died or underwent colectomy secondary to fulminant Clostridium difficile colitis. In patients with C. difficile colitis, a progressive, systemic inflammatory state may develop that is unresponsive to medical therapy; it may progress to colectomy or death. The authors reviewed 2,334 hospitalized patients with C. difficile colitis from January 1989 to December 2000. Sixty-four patients died or underwent colectomy for pathologically proven C. difficile colitis. In 2000, the incidence of C. difficile colitis in hospitalized patients increased from a baseline of 0.68% to 1.2%, and the incidence of patients with C. difficile colitis in whom life-threatening symptoms developed increased from 1.6% to 3.2%. Forty-four patients required a colectomy and 20 others died directly from C. difficile colitis. Twenty-two percent had a prior history of C. difficile colitis. A recent surgical procedure and immunosuppression were common predisposing conditions. Lung transplant patients were 46 times more likely to have C. difficile colitis and eight times more likely to have severe disease. Abdominal computed tomography scan correctly diagnosed all patients, whereas 12.5% of toxin assay...Continue Reading

Associated Clinical Trials

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Jul 4, 2020·Southern Medical Journal·Nasim Ahmed, Yen-Hong Kuo
Feb 18, 2017·The Journal of Critical Care Medicine·Irina Magdalena DumitruLiliana Ana Tuta
Dec 2, 2020·Zeitschrift für Gastroenterologie·Torsten KucharzikCollaborators:
Dec 18, 2020·Arquivos De Gastroenterologia·Daniel Antônio de Albuquerque TerraLuiz Gonzaga Vaz Coelho
Nov 19, 2014·Deutsches Ärzteblatt International·Christoph LübbertLutz von Müller
Mar 8, 2013·Deutsches Ärzteblatt International·Alexander KlegerGeorg Härter
Feb 16, 2008·The American Surgeon·Syed O AliRobert J Dring
Feb 19, 2021·Clinical Case Reports·Kazutaka FukushimaKent Doi
Sep 30, 2018·American Journal of Surgery·Bradley R HallDmitry Oleynikov
Jan 22, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Abbas Hatim RupawalaColleen R Kelly
Mar 27, 2021·Diseases of the Colon and Rectum·Vitaliy PoylinPrepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons.
Sep 9, 2009·Indian Journal of Medical Microbiology·C Vaishnavi
Jan 2, 2021·Microbiology Spectrum·Lee W Riley
Jun 24, 2016·Microbiology Spectrum·Jae Hyun ShinCirle A Warren
May 24, 2021·Gastroenterology Clinics of North America·Lemuel R Non, Dilek Ince
May 21, 2021·Journal of the American College of Surgeons·Elisa Morales-MarroquinSarah E Messiah
Jun 9, 2021·Therapeutic Advances in Gastroenterology·Akshita Gupta, Ashwin N Ananthakrishnan

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