Histologic Findings and Clinical Characteristics in Acutely Symptomatic Ulcerative Colitis Patients With Superimposed Clostridium difficile Infection

Tao Wang; Streutker, Catherine J.; Matukas, Larissa
December 2013
American Journal of Clinical Pathology;Dec2013, Vol. 140 Issue 6, p831
Academic Journal
Objectives: To examine biopsy specimens for histologic features suggestive of Clostridium difficile infection in patients with ulcerative colitis (UC). Methods: Nine patients with UC had colonic biopsy specimens taken during a symptomatic flare that coincided with positive C difficile (C difficile+) tests. Twenty-eight controls were biopsied during a UC flare but tested negative for C difficile. We reviewed the slides for evidence of pseudomembranes, ischemic-like changes, degree of colitis, and lamina propria hemorrhage. Results: In C difficile+ patients, 4 (44.4%) of 9 had microscopic pseudomembranes compared with 11% in controls (P < .05). Other histologic/clinical features were not predictive. Conclusions: Although the presence of microscopic pseudomembranes suggests C difficile infection in patients with UC, sensitivity and specificity are poor; biopsy findings do not reliably detect this infection in patients with UC.


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