What endoscopy findings indicate Clostridium difficile (C diff) infection (CDI)?

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

Although endoscopy is not routinely recommended for the diagnosis or management of C difficile infection (CDI), this procedure may demonstrate the presence of raised, yellowish white, 2- to 10-mm plaques overlying an erythematous, edematous mucosa. These plaques are termed pseudomembranes (see the following images). Pseudomembranes are observed in 14-25% of patients with mild C difficile disease and 87% of patients with fulminant disease.

Clostridioides (Clostridium) difficile colitis. Gr Clostridioides (Clostridium) difficile colitis. Gross pathology specimen from a case of pseudomembranous colitis revealing the characteristic yellowish plaques.
Clostridioides (Clostridium) difficile colitis. Gr Clostridioides (Clostridium) difficile colitis. Gross pathology specimen from a case of pseudomembranous colitis, again demonstrating the characteristic yellowish plaques.
Clostridioides (Clostridium) difficile colitis. Co Clostridioides (Clostridium) difficile colitis. Colonic pseudomembranes of pseudomembranous colitis. Photographs courtesy of Eric M. Osgard, MD.

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