Clostridium difficile infection history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.

Overview

Clinical manifestations may range from an asymptomatic course to a severe/fatal presentation. Common symptoms include acute-onset, foul-smelling watery diarrhea, crampy diffuse or lower abdominal pain, low-grade fever, malaise, anorexia, nausea, and weight loss. Alarming symptoms that may be suggestive of colonic complications of C. difficile infection include worsening abdominal pain and diarrhea, high-grade fever, dry mucus membranes, and peripheral edema.

History and Symptoms

Clinical manifestations may range from an asymptomatic course to a severe/fatal presentation.

Common symptoms

• Acute-onset, foul-smelling watery diarrhea with or without pus. Diarrhea may occasionally be bloody. Diarrhea may be relieved by passage of stools.
• Crampy, diffuse/lower abdominal pain
• Low-grade fever
• Malaise
• Anorexia
• Nausea
• Weight loss

Alarming symptoms suggestive of colonic complications

Patients with C. difficile infection may have a complicated clinical course due to either colonic or extracolonic complications. Common colonic complications include pseudomembranous colitis and toxic megacolon. The following list of symptoms demonstrates the alarming symptoms that may be suggestive of colonic complications of C. difficile infection:

• Worsening diffuse/lower abdominal pain
• Foul smelling, watery diarrhea with or without pus or blood. Diarrhea may be relieved by passage of stools.
• High-grade fever
• Dry mouth and mucus membranes due to dehydration
• Peripheral edema due to hypoalbuminemia
• Delirium
• Coma

References

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