CLOSTRIDIUM-DIFFICILE COLITIS - CORRELATION OF CT FINDINGS WITH SEVERITY OF CLINICAL-DISEASE

Clinical records and abdominal CT scans from 64 patients with document ed Clostridium difficile disease were reviewed to determine if any cor relation existed between CT findings of colitis and severity of clinic al disease. Clostridium difficile disease was documented with stool to xin titre levels and CT scans were performed within 3 days of stool sa mple. Clinical disease severity was estimated by tabulating the degree of fever, WBC count, frequency and duration of diarrhoea. Thirty-nine of 64 patients showed CT evidence of colitis of which 28/39 showed ev idence of focal colitis and 11/39 had pancolitis. CT findings suggesti ng colitis included colonic wall thickening (39 patients), nodular muc osal thickening (11 patients), the 'accordion pattern' (3 patients), p ericolonic oedema (27 patients) and ascites (10 patients). Twenty-five of 64 patients showed no CT evidence of colitis. The clinical severit y of disease did not statistically differ (P < 0.05) between patients with CT evidence of colitis and those without colitis. The only CT fin ding that correlated with clinical severity of disease was nodular muc osal thickening which was found with significantly (P < 0.05) more fre quency in patients with a WBC count > 11000 mm(3). CT changes with Cl. difficile disease correlate poorly with the clinical severity. This a nd negative findings do not exclude the disease.