Overview

Clostridioides difficile (klos-TRID-e-oi-deez dif-uh-SEEL) is a bacterium that causes an infection of the colon, the longest part of the large intestine. Symptoms can range from diarrhea to life-threatening damage to the colon. The bacterium is often called C. difficile or C. diff.

Illness from C. difficile often occurs after using antibiotic medicines. It mostly affects older adults in hospitals or in long-term care settings. People not in care settings or hospitals also can get C. difficile infection. Some strains of the bacterium that can cause serious infections are more likely to affect younger people.

The bacterium used to be called Clostridium (klos-TRID-e-um) difficile.

Symptoms

Symptoms often begin within 5 to 10 days after starting an antibiotic. But symptoms can occur as soon as the first day or up to three months later.

Mild to moderate infection

The most common symptoms of mild to moderate C. difficile infection are:

• Watery diarrhea three or more times a day for more than one day.
• Mild belly cramping and tenderness.

Severe infection

People who have a severe C. difficile infection tend to lose too much bodily fluid, a condition called dehydration. They might need to be treated in a hospital for dehydration. C. difficile infection can cause the colon to become inflamed. It sometimes can form patches of raw tissue that can bleed or make pus. Symptoms of severe infection include:

• Watery diarrhea as often as 10 to 15 times a day.
• Belly cramping and pain, which may be severe.
• Fast heart rate.
• Loss of fluids, called dehydration.
• Fever.
• Nausea.
• Increased white blood cell count.
• Kidney failure.
• Loss of appetite.
• Swollen belly.
• Weight loss.
• Blood or pus in the stool.

C. difficile infection that is severe and sudden can cause the colon to become inflamed and get larger, called toxic megacolon. And it can cause a condition called sepsis where the body’s response to an infection damages its own tissues. People who have toxic megacolon or sepsis are admitted to an intensive care unit in the hospital. But toxic megacolon and sepsis aren’t common with a C. difficile infection.

When to see a doctor

Some people have loose stools during or shortly after antibiotic therapy. This may be caused by C. difficile infection. Make a health care appointment if you have:

• Three or more watery stools a day.
• Symptoms lasting more than two days.
• A new fever.
• Severe belly pain or cramping.
• Blood in your stool.

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