Indications for operative management in patients with CDI

A diagnosis of CDI as determined by one of the following:

Positive laboratory assay for C. difficile
Colonoscopic findings consistent with C. difficile colitis
CT scan findings consistent with C. difficile colitis (pancolitis with or without ascites)

Plus any one of the following criteria:

Peritonitis
Colonic perforation or full-thickness ischemia
Sepsis
Respiratory failure requiring intubation and mechanical ventilation
Vasopressor requirement after resuscitation
Mental status changes attributable to C. difficile colitis
Clinical deterioration despite adequate medical management
Acute renal failure (or other worsening end-organ failure)
Serum lactate level >5 mmol/L
White blood cell count greater than or equal to 50,000 cells/mL
Abdominal compartment syndrome or intra-abdominal hypertension

CDI: Clostridioides (formerly Clostridium) difficile infection; CT: computed tomography.

Original table modified for this publication. From: Hrebinko K, Zuckerbraun BS. Clostridium difficile: What the surgeon needs to know. Semin Colon Rectal Surg 2018; 29:28. Table used with the permission of Elsevier Inc. All rights reserved.

Graphic 119208 Version 2.0

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Indications for operative management in patients with CDI