ANTIBIOTIC-INDUCED DIARRHEA - SPECIFICITY OF ABDOMINAL CT FOR THE DIAGNOSIS OF CLOSTRIDIUM-DIFFICILE DISEASE

PURPOSE: To evaluate the specificity of abdominal computed tomography (CT) in the diagnosis of Clostridium difficile disease. MATERIALS AND METHODS: The authors retrospectively reviewed CT scans of 64 patients with C difficile disease and 30 control subjects with diarrhea and neg ative findings for C difficile disease at stool tests. RESULTS: Colon wall thickening (range, 4-22 mm; mean, 11.7 mm; median, 11 mm) was see n in 39 patients (61%) with C difficile disease. Other findings includ ed focal colon wall thickening (n = 28) and pancolonic thickening (n = 11). Two patients had only right-sided and transverse colon involveme nt. CT-specific diagnostic features of C difficile disease, such as no dular haustral thickening or the accordion pattern, were present in 17 % of patients. No colonic abnormality was detected in 25 patients (39% ). Seven of the 30 (23%) control subjects had colon wall thickening. S ix of those seven subjects were subsequently determined to have ischem ic colitis. The sensitivity of CT in the detection of colon abnormalit ies in patients with C difficile disease was 85%, and the specificity was 48%. CONCLUSION: Specific CT features of C difficile disease are u ncommon. A considerable number of patients (39%) with C difficile dise ase have normal abdominal CT scans.