title: Clostridium difficile: association with thrombocytosis and leukocytosis.
abstract: BACKGROUND
  Apart from leukocytosis, few laboratory markers suggestive of Clostridium difficile infections have been described.
  
  
  METHODS
  We retrospectively analyzed the association between thrombocytosis, leukocytosis and C. difficile infections at the Atlanta Veterans Affairs Medical Center.
  
  
  RESULTS
  Of 162 patients with C. difficile infection, 36 (22%) had thrombocytosis, and 97 (60%) had leukocytosis. C difficile toxin A ELISA was performed in 46/695 (6.6%) patients with thrombocytosis and was positive in 18 (39.1%). Leukocytosis was present in 16/18 (89%) of patients with positive C. difficile toxin A ELISA and thrombocytosis, but also in 21/28 (75%) of patients with negative C. difficile toxin A ELISA and thrombocytosis. Among patients with marked leukocytosis, C. difficile toxin A was more frequently detected in those with concomitant thrombocytosis (P = 0.07).
  
  
  CONCLUSIONS
  The presence of thrombocytosis may be helpful to improve the pretest probability for C difficile infections.
authors.affiliation: Division of Infectious Diseases, Veterans Affairs Medical Center, School of Medicine, Emory University, Atlanta, GA, USA. walbric@emory.edu
authors.forename: Werner C
authors.initials: WC
authors.lastname: Albrich
authors.forename: David
authors.initials: D
authors.lastname: Rimland
mesh_terms: D001427:Bacterial Toxins / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D004768:Enterotoxins / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D016695:Glycosyltransferases; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D010976:Platelet Count; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013922:Thrombocytosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology*
chemical_list: D001427:Bacterial Toxins; D015415:Biomarkers; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; D016695:Glycosyltransferases