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Corticosteroid exposure within 2 weeks of the diagnosis of CDI was also associated with a twofold increase in mortality (153). Patients with IBD have a higher rate of colectomy and a greater mortality than either non-CDI IBD or non-IBD CDI controls (135,137,150). The clinical presentation of an IBD flare and CDI often is indistinguishable and requires a high index of suspicion for prompt detection and institution of appropriate therapy.
All patients who require hospitalization because of an IBD flare, as well as ambulatory patients with risk factors for CDI (e.recent hospitalization, antibiotic use) or unexplained worsening of symptoms in the setting of previously quiescent disease, should be tested for C.