Commentaries
Prognosis in Clostridium difficile infection complicating inflammatory bowel disease
Correspondence to:
Dr Christian D Stone, Director, Inflammatory Bowel Disease Program, Assistant Professor of Medicine, Division of Gastroenterology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8124, Saint Louis, Missouri 63110, USA; cstone@wustl.edu
| The first 150 words of the full text of this article appear below. |
Since the earliest descriptions of Clostridium difficile as a cause of pseudomembranous colitis,1 clinicians have been familiar with the typical clinical setting in which infection can arise. It is well recognised that, classically, infection follows exposure to antibiotics targeting gut anaerobes and that transmission occurs nosocomially from one host to another.2 Yet, it has also been appreciated that the role that this Gram-positive bacillus plays in the colonic flora is complex and the circumstances that promote infection are variable. Early on, for instance, the term C difficile-associated disease (CDAD) came into use as it became apparent that positive stool testing failed to distinguish between an asymptomatic carrier state and true infection. Adoption of this term is an example of how physicians have had to adjust to the knowledge that has accumulated about this opportunistic organism. Over time, our understanding of C difficile has continued to expand and it is
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