{"id":2318,"date":"2017-01-06T15:42:11","date_gmt":"2017-01-06T15:42:11","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/infscd\/"},"modified":"2026-03-12T20:27:25","modified_gmt":"2026-03-12T20:27:25","slug":"infscd","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/infscd\/","title":{"rendered":"Severity Criteria for Clostridium difficile Infection"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div>Patients with severe disease may develop a colonic ileus or toxic dilatation and present with abdominal pain and distension but with minimal or no diarrhea. Complications of severe C. difficile colitis include dehydration, electrolyte disturbances, hypoalbuminemia, toxic megacolon, bowel perforation, hypotension, renal failure, systemic inflammatory response syndrome, sepsis, and death.<\/div>\n<div><!--more--><\/div>\n<div><\/div>\n<div>\n<div>\n<div><b>Severity Criteria for Clostridium difficile Infection<\/b><\/div>\n<div>\n<div><\/div>\n<div>The severity of episodes of C. difficile diarrhoea are classified according to the following guidelines:<\/div>\n<div><\/div>\n<div>Mild<\/div>\n<div>\n<ul>\n<li>normal white blood cell count (WCC)<\/li>\n<li>stool frequency less than three per day and<\/li>\n<li>stool consistency type 5\u20137 on Bristol Stool Form Scale.<\/li>\n<\/ul>\n<\/div>\n<div>Moderate<\/div>\n<div>\n<ul>\n<li>WCC raised but &lt;15 \u00d710<sup>9<\/sup>\/l and<\/li>\n<li>stool frequency three to five per day.<\/li>\n<\/ul>\n<\/div>\n<div>Severe<\/div>\n<div>\n<ul>\n<li>WCC raised but &gt;15 \u00d710<sup>9<\/sup>\/l or<\/li>\n<li>an acute rising serum creatinine (&gt;50% increase above baseline) or<\/li>\n<li>temperature &gt;38.5 \u00b0C or<\/li>\n<li>evidence of severe colitis (based on clinical examination or imaging).<\/li>\n<\/ul>\n<\/div>\n<div>Life-threatening<\/div>\n<div>\n<ul>\n<li>hypotension or<\/li>\n<li>partial or complete ileus or<\/li>\n<li>toxic megacolon or<\/li>\n<li>radiological evidence of severe disease.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div><\/div>\n<div><strong>Requirement for intensive care unit (ICU) admission<\/strong><\/div>\n<div>The presence of at least 2 of the following factors:<\/div>\n<div>\n<ol>\n<li>Age &gt;70 years<\/li>\n<li>Leukocytosis &gt;15,000 cells\/mm3<\/li>\n<li>Deviation to the left marked (segmented neutrophils &gt; 20% of the leukocyte count)<\/li>\n<li>Increased creatinine &gt;\/= 1.5 times baseline<\/li>\n<li>Serum lactate &gt; 2.5 mmol\/l<\/li>\n<li>Temperature &gt; 38.5 \u00b0C<\/li>\n<li>Multiple daily diarrheal stools (&gt;10 per day)<\/li>\n<li>Presence of paralytic ileus or signs of peritonitis<\/li>\n<li>Albumin &lt;2.5 mg\/dl<\/li>\n<li>Evidence of colitis on CT scan<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div><\/div>\n<div><\/div>\n<div><b>References:<\/b><\/div>\n<div>\n<ol>\n<li>Rodr\u00edguez-Pardo D, Mirelis B, Navarro F. Infections caused by Clostridium difficile. Enferm Infecc Microbiol Clin. 2013 Apr;31(4):254-63.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23411363\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Leffler DA, Lamont JT. Clostridium difficile infection.\u00a0N Engl J Med. 2015 Apr 16;372(16):1539-48.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25875259\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Allen SJ, Wareham K, Wang D, et al. A high-dose preparation of lactobacilli and bifidobacteria in the prevention of antibiotic-associated and Clostridium difficile diarrhoea in older people admitted to hospital: a multicentre, randomised, double-blind, placebo-controlled, parallel arm trial (PLACIDE). Health Technology Assessment, No. 17.57. Southampton (UK): NIHR Journals Library; 2013 Dec.\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK261330\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Kelly CR, Allegretti JR. Review Article: Gastroenterology and Clostridium difficile Infection: Past, Present, and Future. Clin Infect Dis. 2023 Dec 5;77(Suppl 6):S463-S470. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38051967\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<\/div>\n<div><\/div>\n<div><\/div>\n<div>Created Jan 06, 2017.<br \/>\nUp-date Mar 12, 2026.<\/div>\n<\/div>\n<div><\/div>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[39],"tags":[663,16,15,182,266,267,226,180],"class_list":["post-2318","post","type-post","status-publish","format-standard","hentry","category-infetious-disease","tag-clostridium-difficile","tag-criteria","tag-criterios","tag-gravedad","tag-infeccion","tag-infection","tag-severidad","tag-severity"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2318"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2318\/revisions"}],"predecessor-version":[{"id":10708,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2318\/revisions\/10708"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}