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Pseudomembranous Colitis
Michael R. Aquino, MD, MHSc
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Antibiotic-associated colitis, Clostridium difficile (C. difficile) colitis, necrotizing colitis
          • Definitions

            • Inflammation of colon by Clostridium difficile toxins A & B

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Choi HH et al: Fecal microbiota transplantation: current applications, effectiveness, and future perspectives. Clin Endosc. 49(3):257-65, 2016
                                          2. Wiener-Well Y et al: Ultrasound diagnosis of Clostridium difficile-associated diarrhea. Eur J Clin Microbiol Infect Dis. 34(10):1975-8, 2015
                                          3. Hookman P et al: Clostridium difficile associated infection, diarrhea and colitis. World J Gastroenterol. 15(13):1554-80, 2009
                                          4. Zilberberg MD et al: Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005. Emerg Infect Dis. 14(6):929-31, 2008
                                          5. Nelson R: Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. Cochrane Database Syst Rev. (3):CD004610, 2007
                                          6. Ramachandran I et al: Pseudomembranous colitis revisited: spectrum of imaging findings. Clin Radiol. 61(7):535-44, 2006
                                          7. Razzaq R et al: Ultrasound diagnosis of clinically undetected Clostridium difficile toxin colitis. Clin Radiol. 61(5):446-52, 2006
                                          8. Thoeni RF et al: CT imaging of colitis. Radiology. 240(3):623-38, 2006
                                          9. Hussain SZ et al: Clostridium difficile colitis in children with cystic fibrosis. Dig Dis Sci. 49(1):116-21, 2004
                                          10. Oldfield EC 3rd: Clostridium difficile-associated diarrhea: risk factors, diagnostic methods, and treatment. Rev Gastroenterol Disord. 4(4):186-95, 2004
                                          11. Lembcke B et al: Antibiotic-associated diarrhea: therapeutic aspects and practical guidelines--an interdisciplinary approach to a common problem. Schweiz Rundsch Med Prax. 92(17):809-16, 2003
                                          12. Spivack JG et al: Clostridium difficile-associated diarrhea in a pediatric hospital. Clin Pediatr (Phila). 42(4):347-52, 2003
                                          13. Hurley BW et al: The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Arch Intern Med. 162(19):2177-84, 2002
                                          14. Iseman DT et al: Pseudomembranous (Clostridium difficile) colitis. Gastrointest Endosc. 56(6):907, 2002
                                          15. Kirkpatrick ID et al: Evaluating the CT diagnosis of Clostridium difficile colitis: should CT guide therapy? AJR Am J Roentgenol. 176(3):635-9, 2001
                                          16. Kawamoto S et al: Pseudomembranous colitis: spectrum of imaging findings with clinical and pathologic correlation. Radiographics. 19(4):887-97, 1999
                                          17. Ros PR et al: Pseudomembranous colitis. Radiology. 198(1):1-9, 1996
                                          18. Fishman EK et al: Pseudomembranous colitis: CT evaluation of 26 cases. Radiology. 180(1):57-60, 1991
                                          19. Stanley RJ et al: The spectrum of radiographic findings in antibiotic-related pseudomembranous colitis. Radiology. 111(3):519-24, 1974
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Antibiotic-associated colitis, Clostridium difficile (C. difficile) colitis, necrotizing colitis
                                                  • Definitions

                                                    • Inflammation of colon by Clostridium difficile toxins A & B

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • Fluoroscopic Findings

                                                        • CT Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Choi HH et al: Fecal microbiota transplantation: current applications, effectiveness, and future perspectives. Clin Endosc. 49(3):257-65, 2016
                                                                                  2. Wiener-Well Y et al: Ultrasound diagnosis of Clostridium difficile-associated diarrhea. Eur J Clin Microbiol Infect Dis. 34(10):1975-8, 2015
                                                                                  3. Hookman P et al: Clostridium difficile associated infection, diarrhea and colitis. World J Gastroenterol. 15(13):1554-80, 2009
                                                                                  4. Zilberberg MD et al: Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005. Emerg Infect Dis. 14(6):929-31, 2008
                                                                                  5. Nelson R: Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. Cochrane Database Syst Rev. (3):CD004610, 2007
                                                                                  6. Ramachandran I et al: Pseudomembranous colitis revisited: spectrum of imaging findings. Clin Radiol. 61(7):535-44, 2006
                                                                                  7. Razzaq R et al: Ultrasound diagnosis of clinically undetected Clostridium difficile toxin colitis. Clin Radiol. 61(5):446-52, 2006
                                                                                  8. Thoeni RF et al: CT imaging of colitis. Radiology. 240(3):623-38, 2006
                                                                                  9. Hussain SZ et al: Clostridium difficile colitis in children with cystic fibrosis. Dig Dis Sci. 49(1):116-21, 2004
                                                                                  10. Oldfield EC 3rd: Clostridium difficile-associated diarrhea: risk factors, diagnostic methods, and treatment. Rev Gastroenterol Disord. 4(4):186-95, 2004
                                                                                  11. Lembcke B et al: Antibiotic-associated diarrhea: therapeutic aspects and practical guidelines--an interdisciplinary approach to a common problem. Schweiz Rundsch Med Prax. 92(17):809-16, 2003
                                                                                  12. Spivack JG et al: Clostridium difficile-associated diarrhea in a pediatric hospital. Clin Pediatr (Phila). 42(4):347-52, 2003
                                                                                  13. Hurley BW et al: The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Arch Intern Med. 162(19):2177-84, 2002
                                                                                  14. Iseman DT et al: Pseudomembranous (Clostridium difficile) colitis. Gastrointest Endosc. 56(6):907, 2002
                                                                                  15. Kirkpatrick ID et al: Evaluating the CT diagnosis of Clostridium difficile colitis: should CT guide therapy? AJR Am J Roentgenol. 176(3):635-9, 2001
                                                                                  16. Kawamoto S et al: Pseudomembranous colitis: spectrum of imaging findings with clinical and pathologic correlation. Radiographics. 19(4):887-97, 1999
                                                                                  17. Ros PR et al: Pseudomembranous colitis. Radiology. 198(1):1-9, 1996
                                                                                  18. Fishman EK et al: Pseudomembranous colitis: CT evaluation of 26 cases. Radiology. 180(1):57-60, 1991
                                                                                  19. Stanley RJ et al: The spectrum of radiographic findings in antibiotic-related pseudomembranous colitis. Radiology. 111(3):519-24, 1974