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recent hospitalization, antibiotic use) or unexplained worsening of symptoms in the setting of previously quiescent disease, should be tested for C.
difficile. Escalation of immunosuppression medications should be avoided in the setting of untreated CDI. (Conditional recommendation, low-quality evidence). Management of concomitant immunosuppression in such patients is challenging, including when to treat a patient for CDI when they present with what appears to be an exacerbation of IBD.