What are the roles of WBC count and serum creatinine in the evaluation of Clostridium difficile (C diff) colitis?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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Answer

Leukocytosis is common in C difficile infection (CDI) and the white blood cell (WBC) count levels may be quite elevated, a finding that portends a worse prognosis. Patients with C difficile are also prone to acute kidney injury. Therefore, white blood cell counts and serum creatinine should be measured in patients with C difficile. Because the presence of leukocytosis and renal impairment are indicators of severe infection, patients with these findings should be treated initially with oral vancomycin instead of metronidazole. [5]

In severe disease, electrolyte imbalance, dehydration, hypoalbuminemia, and anasarca may occur, and patients should be monitored periodically. If surgical intervention is being considered, serum lactate levels and white blood cell counts may aid clinicians in their decision making.


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