Letter to the Editor

Diagnosing of Clostridium difficile Colitis

Authors: Viroj Wiwanitkit, MD

Abstract

To the Editor:


I read the recent publication by Gade and Turett1 with great interest. Gade and Turett1 emphasized the utility of repeated stool toxin testing for the diagnosing of Clostridium difficile colitis. Indeed, the repeated testing for stool toxin is an accepted method to overcome the problem of an initial false negative. However, lack of value of this practice is mentioned in some papers.2 Since Clostridium difficile colitis is a serious infection and early diagnosis is needed, the use of a more accurate technique than repeated analysis is needed. Morelli et al noted that the toxin B gene polymerase chain reaction was a more sensitive and cost-effective method to diagnose Clostridium difficile-induced diarrhea and should be considered for use as an alternative diagnostic standard.3


Viroj Wiwanitkit, MD


Wiwanitkit House, Bangkhae


Bangkok, Thailand

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References

1.Gade R, Turett G. The utility of repeated stool toxin testing for diagnosing Clostridium difficile colitis. South Med J 2009;102:1007–1009.
 
2.Mohan SS, McDermott BP, Parchuri S, et al. Lack of value of repeat stool testing for Clostridium difficile toxin. Am J Med 2006;119:356.e7–356.e8.
 
3.Morelli MS, Rouster SD, Giannella RA, et al. Clinical application of polymerase chain reaction to diagnose clostridium difficile in hospitalized patients with diarrhea. Clin Gastroenterol Hepatol 2004;2:669–679.