In C. diff stool microscopy, what may be present to indicate infection?

In the context of Clostridium difficile (C. diff) infection, the presence of fecal leukocytes and possibly erythrocytes in stool microscopy indicates inflammation and an immune response to the infection. C. diff typically leads to colitis, which is characterized by the infiltration of white blood cells into the intestinal lumen as the body attempts to fight off the bacterial infection. The detection of fecal leukocytes reflects this inflammatory process.

Erythrocytes may also be present due to damage to the intestinal lining, resulting in bleeding, which can occur with the more severe forms of colitis associated with C. diff. The presence of these cells in stool microscopy is significant because it suggests active inflammation, which is a hallmark of C. diff infection.

In contrast, high levels of glucose are not associated with C. diff infections and do not provide information relevant to the presence of infection. Increased fat globules are indicative of malabsorption rather than a specific infection, while elevated bilirubin levels suggest liver dysfunction or hemolysis and are not directly associated with C. diff colitis. Hence, the presence of fecal leukocytes and possibly erythrocytes serves as a valuable indicator of infection in this context.