title: Harbingers for Clostridium difficile-associated diarrhea.
abstract: OBJECTIVE
  : Recent research has recognized surrogate markers for Clostridium difficile-associated diarrhea (CDAD). Among the most consistently identified markers are the leukocyte count, platelet count, and albumin level. Previous investigators failed to exclude patients with hematologic disorders that may have confounded their results. Therefore, the exclusion of this subset from our study lends it a unique perspective.
  
  
  METHODS
  : We undertook a retrospective review of inpatients at our institution that were diagnosed with nosocomial diarrhea and subsequently had a stool sample sent for C. difficile toxins A and B. Patients with major hematologic disorders were excluded.
  
  
  RESULTS
  : A total of 77 C. difficile-positive patients and 91 C. difficile-negative patients were studied. Patients with CDAD had a significantly higher leukocyte and platelet count but a lower albumin level compared with patients without CDAD.
  
  
  CONCLUSIONS
  : Our results support the conclusion of preceding studies that leukocytosis, thrombocytosis, and hypoalbuminemia are reliable clinical predictors for CDAD even after careful exclusion of confounding factors.
authors.affiliation: Department of Medicine, Louisiana State University Health Science Center, Shreveport, LA, USA. cpant@lsuhsc.edu
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Pant
authors.forename: Phillip N
authors.initials: PN
authors.lastname: Madonia
authors.forename: Paul
authors.initials: P
authors.lastname: Jordan
authors.forename: Kenneth
authors.initials: K
authors.lastname: Manas
authors.forename: Pat
authors.initials: P
authors.lastname: Bass
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D003967:Diarrhea / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult