56 patients with diarrhoea were screened for the presence of Clostridium difficile toxin in their stool. The test was positive in 9: 5 had severe inflammatory bowel disease and were receiving systemic steroids; 2 were on steroids for other conditions; 1 had been on antibiotics; and in 1 there was no apparent predisposing factor. In each case clearance of the toxin was associated with clinical improvement. Evidently Cl. difficile toxin is not specific for antibiotic-associated diarrhoea, but is associated with diarrhoea of various aetiologies, often unrelated to antibiotic therapy. Cl. difficile may be an important factor in some exacerbations of inflammatory bowel disease.
Anti-Bacterial Agents Bacterial Toxins