title: Colonic disease associated with a positive assay for Clostridium difficile toxin: a retrospective study.
abstract: 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.
authors.affiliation: Department of Pathology, Baystate Medical Center, Springfield, Massachusetts 01199, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Nash
authors.forename: R
authors.initials: R
authors.lastname: Bourgeault
authors.forename: M
authors.initials: M
authors.lastname: Sands
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000378:metabolism; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D001427:Bacterial Toxins