caa a22 4500 606156887 CHVBK 20210128100610.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10096-015-2439-1 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2439-1 Ultrasound diagnosis of Clostridium difficile -associated diarrhea [Elektronische Daten] [Y. Wiener-Well, S. Kaloti, I. Hadas-Halpern, G. Munter, A. Yinnon] Clostridium difficile colitis is diagnosed using an immunoassay or polymerase chain reaction (PCR) assay for toxins A/B. Since ultrasound is frequently used as a screening test for hospitalized patients suffering from different abdominal morbidities, we searched for sonographic indicators of C. difficile infection (CDI). In a prospective and blinded case-control study, abdominal ultrasound was performed on hospitalized patients for whom stool samples were sent for C. difficile toxin immunoassay. All patients with positive toxin were included as the case group and patients with negative toxin comprised the control group. Sonographic parameters of both groups were compared. Demographic variables of the 67 patients in the toxin-positive group were similar to those of the 71 patients in the toxin-negative group. The sonographic parameters which were found to be associated with CDI included colonic wall thickening, appearing in 61 (91%) patients of the toxin-positive group versus 15 (21%) patients of the toxin-negative group (p < 0.001), and also internal ring (24 versus 0%, p < 0.001), external ring (15 versus 0%, p < 0.001), ascites (24 versus 10%, p < 0.001), and diminution of large bowel content (16 versus 1%, p < 0.001). Bowel wall thickening had high positive and negative predictive values (0.80 and 0.90, respectively), while the other features had only high positive predictive values (0.7-1.0). Abdominal ultrasound may contribute to the diagnosis of C. difficile colitis in patients developing hospital-acquired diarrhea. Springer-Verlag Berlin Heidelberg, 2015 Wiener-Well Y. Infectious Disease Unit, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, P.O. Box 3235, 91031, Jerusalem, Israel aut Kaloti S. Radiology Department, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut Hadas-Halpern I. Radiology Department, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut Munter G. Division of Internal Medicine, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut Yinnon A. Infectious Disease Unit, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, P.O. Box 3235, 91031, Jerusalem, Israel aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/10(2015-10-01), 1975-1978 0934-9723 34:10<1975 2015 34 10096 https://doi.org/10.1007/s10096-015-2439-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2439-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wiener-Well Y. Infectious Disease Unit, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, P.O. Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Kaloti S. Radiology Department, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut NATIONALLICENCE 700 1- Hadas-Halpern I. Radiology Department, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut NATIONALLICENCE 700 1- Munter G. Division of Internal Medicine, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, Jerusalem, Israel aut NATIONALLICENCE 700 1- Yinnon A. Infectious Disease Unit, Shaare Zedek Medical Center, affiliated with the Hadassah-Hebrew University Medical School, P.O. Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/10(2015-10-01), 1975-1978 0934-9723 34:10<1975 2015 34 10096