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Harbingers for Clostridium difficile-Associated Diarrhea
  1. Chaitanya Pant, MD,
  2. Phillip N. Madonia, MD,
  3. Paul Jordan, MD,
  4. Kenneth Manas, MD,
  5. Pat Bass III, MD
  1. From the Department of Medicine, Louisiana State University Health Science Center, Shreveport, LA.
  1. Received July 27, 2008, and in revised form September 25, 2008.
  2. Accepted for publication September 26, 2008.
  3. Reprints: Chaitanya Pant, MD, Department of Medicine, Louisiana State University Health Science Center, Shreveport. 1501 Kings Highway, Shreveport, LA (e-mail: cpant{at}


Purpose Recent research has recognized surrogate markers for Clostridium difficile-associated diarrhea (CDAD). Among the most consistently identified markers are the leukocyte count, platelet count, and albumin level. Previous investigators failed to exclude patients with hematologic disorders that may have confounded their results. Therefore, the exclusion of this subset from our study lends it a unique perspective.

Methods We undertook a retrospective review of inpatients at our institution that were diagnosed with nosocomial diarrhea and subsequently had a stool sample sent for C. difficile toxins A and B. Patients with major hematologic disorders were excluded.

Results A total of 77 C. difficile-positive patients and 91 C. difficile-negative patients were studied. Patients with CDAD had a significantly higher leukocyte and platelet count but a lower albumin level compared with patients without CDAD.

Conclusion Our results support the conclusion of preceding studies that leukocytosis, thrombocytosis, and hypoalbuminemia are reliable clinical predictors for CDAD even after careful exclusion of confounding factors.

Key Words
  • Clostridium difficile
  • associated diarrhea
  • hypoalbuminemia
  • leukocytosis
  • thrombocytosis

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