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Bedside Prediction of Clostridium difficile Colitis
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 Unpublished letters cannot be returned.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.
TO THE EDITOR:
The John Hopkins group's paper on diagnosing Clostridium difficile colitis [1], several letters to the editor and the Hopkins researchers' reply [2], and Dr. Surawicz's commentary in another journal [3] all discuss clinical associations, laboratory diagnostics, and options. Surprisingly, none mentions that diagnosing this condition is one of the few remaining roles for the highly portable old proctoscope! In these sick patients, if laboratory results are delayed or negative, then, with super suction ready and using left lateral decubitus position (the patient usually in the hospital room and in bed) one can, within a few comfortable inches, appreciate immediately the classic yellowish plaques of pseudomembranous colitis, which rarely spares the rectum. I've seen severe cases of postantibiotic colitis that were toxin-negative by screening tests; a 2- to 3-minute proctal examination revealed classic pseudomembranes and a diagnosis! One efficient clinical look replaced blind empiricism-inexpensive, far simpler than sequential negative laboratory results in a hospitalized patient, and no fiberoptic endoscopy suite charges. Rectal visualization is equally valuable in the office.
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.
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