Severity assessment of C. difficile infection in adults

In adults, features that indicate severe C. difficile infection includeZar, 2007:

• high white cell count (greater than 15 000 cells/mm³)
• severe abdominal pain
• low serum albumin (less than 25 g/L)
• high fever (38.5°C or higher)
• pseudomembranous colitis on endoscopy.

Additional factors supporting the diagnosis of severe C. difficile infection, when available, are distension of the large intestine, pericolonic fat stranding or colonic wall thickening (including low-attenuation mural thickening) at imagingvan Prehn, 2021.

Severe complicated disease in adults is defined as C. difficile infection with any of the following complications:

• sepsis or septic shock (including organ dysfunction and elevated lactate)
• ileus
• perforated viscus
• toxic megacolon.

Rapidly progressing severe disease is known as fulminant disease, which is life threatening and requires urgent intervention.

Adults without severe, complicated or fulminant disease are considered to have mild to moderate disease.