{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:27:34Z","timestamp":1787682454571,"version":"build-2784847793"},"reference-count":12,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["americanjournalofsurgery.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Surgery"],"published-print":{"date-parts":[[2021,1]]},"DOI":"10.1016\/j.amjsurg.2020.06.026","type":"journal-article","created":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T10:15:43Z","timestamp":1592734543000},"page":"240-242","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["Toxic Clostridioides (formerly Clostridium) difficile colitis: No longer a diarrhea associated infection"],"prefix":"10.1016","volume":"221","author":[{"given":"Emmanuel","family":"Nwachuku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhi","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhu","family":"Senthil-Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Braun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Shadis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando","family":"kirton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thai Q.","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.amjsurg.2020.06.026_bib1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.7326\/0003-4819-81-4-429","article-title":"Clindamycin-associated colitis: a prospective trial","volume":"81","author":"Tedesco","year":"1974","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib2","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/S0140-6736(77)90363-4","article-title":"Pseudomembranous colitis: presence of clostridial toxin","volume":"2","author":"Larson","year":"1977","journal-title":"Lancet"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1056\/NEJM197803092981003","article-title":"Antibiotic associated pseudomembranous colitis due to toxin producing clostridia","volume":"298","author":"Bartlett","year":"1978","journal-title":"N\u00a0Engl J Med"},{"issue":"12","key":"10.1016\/j.amjsurg.2020.06.026_bib4","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1093\/cid\/cix959","article-title":"2017 infectious diseases society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea","volume":"65","author":"Shane","year":"2017","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib5","series-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Disease","article-title":"Clostridium difficile infection","author":"Gerding","year":"2015"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib6","series-title":"McGraw-Hill Manual: Colorectal Surgery","article-title":"Disease and problems","year":"2009"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib7","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s11605-015-2785-4","article-title":"Clostridium difficile infection from a surgical perspective","volume":"19","author":"Kaiser","year":"2015","journal-title":"J\u00a0Gastrointest Surg"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib8","doi-asserted-by":"crossref","first-page":"517","DOI":"10.2214\/ajr.172.2.9930816","article-title":"Atypical presentation of Clostridium difficile colitis in patients with cystic fibrosis","volume":"172","author":"Binkovitz","year":"1999","journal-title":"Am J Roentgenol"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/sur.2008.099","article-title":"Unusual manifestations of Clostridium difficile infection","volume":"11","author":"Malkan","year":"2010","journal-title":"Surg Infect"},{"issue":"6","key":"10.1016\/j.amjsurg.2020.06.026_bib10","first-page":"WMC004648","article-title":"Atypical presentation of Clostridium difficile infection (CDI)","volume":"5","author":"Gardezi","year":"2014","journal-title":"Gastroenterology"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib11","first-page":"8","article-title":"Atypical presentation of C. Difficile infection: report of a case with literature review","volume":"8","author":"Khan","year":"2016","journal-title":"Cureus"},{"key":"10.1016\/j.amjsurg.2020.06.026_bib12","first-page":"1136","article-title":"Constipation in Clostridium difficile infection","volume":"10","author":"Kawsar","year":"2012","journal-title":"BMJ Case Rep"}],"container-title":["The American Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961020303792?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961020303792?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:20:11Z","timestamp":1757701211000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002961020303792"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["S0002961020303792"],"URL":"https:\/\/doi.org\/10.1016\/j.amjsurg.2020.06.026","relation":{},"ISSN":["0002-9610"],"issn-type":[{"value":"0002-9610","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Toxic Clostridioides (formerly Clostridium) difficile colitis: No longer a diarrhea associated infection","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjsurg.2020.06.026","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}