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Internal Medicine

Answer 3
  1. Hypermagnesemia. Colitis due to C. difficile may cause a systemic inflammatory response that can manifest with fever as well as several laboratory abnormalities. Leukocytosis is common, with leukocyte counts occasionally exceeding 50 × 103/mm3 (leukemoid reaction), and should prompt consideration of C. difficile colitis. Protein-losing enteropathy may result in profound hypoalbuminemia. Anemia due to acute inflammatory illness and microscopic blood loss is common in patients with C. difficile colitis. Hypokalemia and hypomagnesemia may complicate fluid and electrolyte losses that occur with diarrhea (a symptom of C. difficile colitis); however, hypermagnesemia would not be expected in typical cases.

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