Clostridium difficile: Association with Thrombocytosis and Leukocytosis

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Apart from leukocytosis, few laboratory markers suggestive of Clostridium difficile infections have been described.


We retrospectively analyzed the association between thrombocytosis, leukocytosis and C difficile infections at the Atlanta Veterans Affairs Medical Center.


Of 162 patients with C difficile infection, 36 (22%) had thrombocytosis, and 97 (60%) had leukocytosis. C difficile toxin A ELISA was performed in 46/695 (6.6%) patients with thrombocytosis and was positive in 18 (39.1%). Leukocytosis was present in 16/18 (89%) of patients with positive C difficile toxin A ELISA and thrombocytosis, but also in 21/28 (75%) of patients with negative C difficile toxin A ELISA and thrombocytosis. Among patients with marked leukocytosis, C difficile toxin A was more frequently detected in those with concomitant thrombocytosis (P = 0.07).


The presence of thrombocytosis may be helpful to improve the pretest probability for C difficile infections.

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