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Table 1 Guideline definitions for CDI severity

From: Sleeping with the enemy: Clostridium difficile infection in the intensive care unit

Severity Infectious Diseases Society of America European Society of Clinical Microbiology and Infectious Diseases American College of Gastroenterology
Mild disease    Diarrhea as only symptom
Moderate disease    Symptoms apart from diarrhea not meeting the definition of severe or complicated CDI
Severe disease   Serum albumin < 30 g/l
Serum albumin < 30 g/l
  Leukocytosis > 15,000/µlor Leukocytosis > 15,000/μl
Leukocytosis > 15,000/μl
  Creatinine > 1,5 × ULN Creatinine > 1.5 × ULN
   ‘Clinical markers of severe colitis’ (i.e., fever, rigors, shock, respiratory failure, peritonitis, ascites, ileus, elevated serum lactate, pseudomembranes) Abdominal Tenderness
Complicated disease Hypotension / shock
Significant systemic toxin effects and shock with need for ICU admission, colectomy, or death Admission to ICU, hypotension, fever > 38.5 °C, mental status changes, ileus or significant abdominal distension, serum lactate > 2.2 mmol/l, leukocytosis > 35,000/μl, signs of end-stage organ failure
  Ileus, megacolon
Fulminant CDI Not defined Not defined Not defined
  1. CDI Clostridium difficile infection, ICU intensive care unit, ULN upper limit of normal