Published in IJCP
Pseudomembranous Colitis: Do we Need a Screening?
March 11, 2019 | Ashish Gautam, Prabhat Agrawal, Abhishek Raj, Ashwini K Nigam, Subhash Chandra, Manish K Bansal
In the last few decades, increasing use of antibiotics has dramatically increased the incidence of antibiotic-associated diarrhea.
An unopposed homing of Clostridium difficile in intensive care unit (ICU) and wards puts forward new challenges for physicians.
Development of diarrhea during or just after hospital stay, especially in old patients, is a typical clinical presentation of C.
difficile diarrhea. Cytotoxin assay from tissue culture is a gold standard diagnostic test but its poor availability, high cost, time
bound results and rapid development of life-threatening complications made us to think of a screening test. Demonstration
of pathognomonic summit lesions and pseudomembrane with colonoscopy or sigmoidoscopy is relatively inexpensive, easily
available and diagnosis is prompt. Our experience in few patients with colonoscopy makes us recommend it as a screening test
for all clinically suspected patients. It is refuted as first-line investigation because of good number of false negative results but
demonstration of pathognomonic lesions even in few patients saves the life with minimal expenditure and least time wastage
before initiation of definitive treatment.