Pseudomembranous Colitis Surgery Differential Diagnoses

Updated: Feb 16, 2023
  • Author: Said Fadi Yassin, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Diagnostic Considerations

Conditions to be considered in the differential diagnosis include the following:

  • Staphylococcal enterocolitis and typhlitis - These entities, which were more prevalent before the advent of antibiotics that caused an etiologic shift favoring the emergence of C difficile, are currently observed in patients receiving chemotherapy, who may present with clinical symptoms similar to those of C difficile colitis; they should be suspected when gram-positive cocci are identified on Gram stain of stool smear with negative results for C difficile tests and when the terminal ileum is involved in the disease
  • HIV infection - This virus can cause a similar inflammatory process
  • Acute exacerbation of Crohn disease and ulcerative colitis - Pseudomembranous colitis could be a superimposed infection in these chronic patients. In cases of acute symptoms that do not respond to standard therapy, investigation and therapy for C difficile should be considered, especially when a history of antibiotics exposure is present
  • Chemical colitis - This can occur after chemotherapy and gold exposure
  • Ischemic colitis
  • Other types of bacterial colitis - Colitis may be caused by Campylobacter species, C perfringens, Salmonella species, Shigella species, Escherichia coli, and Yersinia species