C. difficile Colonization

2 patients have a C. difficile PCR test and toxin EIA.

1: has cirrhosis, takes lactulose, normal WBC, no changes in diarrhea
2: febrile, took ciprofloxacin last week, having diarrhea

Which patient(s) should be treated for C. difficile?

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Best Answer:

Patient 2 👨🏻‍🦰

Explanation: This testing result may represent C. difficile colonization OR true infection. Clinical presentation should guide treatment decisions. Patient 2 👨🏻‍🦰 has new diarrhea and infectious signs after taking antibiotics, consistent with C. difficile infection 💩

Patient 1 🧔🏽 is having diarrhea but it is likely a medication side effect. He also reports no changes in bowel habits, making acute C. difficile less likely. However he should be closely monitored!