Comparative Value of Sigmoidoscopy and Stool Cytotoxin-A Assay for Diagnosis of Pseudomembranous Colitis |
Jin Kwang Lee, Joo Yeon Cho, You Sun Kim, Seong Eun Kim, Soo Hyung Ryu, Jung Whan Lee, Jeong Seop Moon |
Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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위막성 대장염에서 S상 결장내시경과 대변 C. difficile 독소검사의 유용성 비교 |
이진광, 조주연, 김유선, 김성은, 류수형, 이정환, 문정섭 |
인제대학교 의과대학 내과학교실 |
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Abstract |
Background/Aims Stool cytotoxin-A assay has been used clinically and commonly for diagnosis of C. difficile associated diarrhea (CDAD). However, the incidence and severity of CDAD show increasing tendency with frequent use of antibiotics, rapid diagnosis is required for severe CDAD. Therefore, we compared diagnostic value of sigmoidoscopy with that of stool cytotoxin-A assay for diagnosis of pseudomembranous colitis (PMC). Methods: During the period from April 2004 to April 2005, a total of 28 cases of suspected CDAD were analyzed prospectively. Both flexible sigmoidoscopy and enzyme immunoassay for stool cytotoxin-A assay were performed and compared with diagnostic yield. The clinical manifestation and used antibiotics were analyzed. Results: The PMC was developed frequently in old age and had clinical symptoms such as diarrhea, abdominal pain and mild fever. The diagnostic yield of stool cytotoxin-A assay was 36.8% while the sigmoidoscopy was 73.6% without significance. With the stool cytotoxin-A assay, the diagnosis for CDAD including PMC was delayed to mean 4.7 days. Conclusions: With increasing use of antibiotics, the incidence and severity of CDAD were increasing. The rapid diagnosis by sigmoidoscopy is more helpful to management of severe CDAD such as PMC than stool cytotoxin-A assay. (Intest Res 2005;3:61-67) |
Key Words:
Antibiotic-associated diarrhea, Pseudomembranous colitis, Clostridium difficile toxin A, Sigmoidoscopy |
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