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Diagnosis of Clostridium difficile Colitis
- Anil Minocha, MD; and
- Robert J. Richards, MD
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•Type with double-spacing
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Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
Manabe and colleagues [1] have provided valuable guidelines for diagnosing C. difficile colitis in hospitalized patients. The study group was defined as patients who had C. difficile toxin as shown by enzyme-linked immunoassay or cytotoxin tissue culture assay. Although this definition of C. difficile colitis is adequate for clinical purposes, we should remember that the presence of C. difficile toxin is not always associated with C. difficile colitis. On the basis of a positive cytotoxin tissue culture assay, C. difficile was present in 34 of 268 patients (12.7%) in Manabe and colleagues' study. This prevalence is similar to that of C. difficile positivity seen in 5% to 15% of adults who were treated with antimicrobial agents but did not have related diarrhea [2]. Thus, it would be interesting to know the prevalence of C. difficile positivity in the patients in Manabe and coworkers' study who received antibiotics but did not have diarrhea.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
