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Closing in on C. difficile

Bloody Diarrhea on a Hospital Ward

We are asked to investigate an outbreak of severe bloody diarrhea on a hospital ward. Cases vary widely with respect to age and underlying illness. Two of the patients have died.

As we enter available clinical and epidemiological data into GIDEON, a short differential diagnosis list evolves in the box to the right.

Assuming that this outbreak is due to a single infectious disease, Clostridium difficile colitis is assigned a statistical probability of 60%. The Bayesian matrix which drives GIDEON will further focus the differential diagnosis if we entering additional signs, symptoms and epidemiological details. Note that suspicion of “Ingestion” (listed first in the upper “Suggestions” box) is a particularly valuable hint in this regard. If we add that “Ingestion” is not relevant to the outbreak, the probability of Clostridium difficile colitis increases to virtually 100%.

Note that the lower right box classifies two additional conditions as “first-case” scenario diseases; ie, these cases are not currently endemic to the country in question (United States), but could represent the first cases of Ebola or SFTS in some future event.

An additional option at this point allows users to generate custom clinical-comparison charts that include any combination of relevant diseases:

So what is Clostridium difficile, and what are its clinical and epidemiological characteristics? The phenotypic fingerprint of this taxon is outlined in the Microbiology Module:

The user can generate a custom chart contrasting the features of Clostridium difficile with those of other clostridia.

Extensive data outline the status of Clostridium difficile colitis on both the global level and within each individual country. The following are abstracted from the United States note: