Clostridium Difficile Colitis (Antibiotic-Associated Colitis, C. difficile Colitis, C. diff, C diff,)

  • Medical Author:
    Dennis Lee, MD

    Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Symptoms of C. difficile Colitis

Individuals with mild C. difficile colitis may have:

  • a low-grade fever,
  • mild diarrhea (5-10 watery stools a day),
  • mild abdominal cramps and tenderness.

Those with severe C. difficile colitis may have:

  • a high fever (temperature of 102 F to 104 F),
  • severe diarrhea (more than 10 watery stools a day) with blood, and
  • severe abdominal pain and tenderness.

Severe diarrhea also can lead to dehydration and disturbances in the electrolytes (minerals) in the body. Rarely, severe colitis can lead to life-threatening complications such as megacolon (markedly dilated colon), peritonitis (inflammation of the lining of the abdominal), and perforation of the colon.

Quick GuideBacterial Infections 101: Types, Symptoms, and Treatments

Bacterial Infections 101: Types, Symptoms, and Treatments

Clostridium difficile (C. difficile) facts

  • Clostridium difficile colitis is an infection of the colon by the bacterium, Clostridium difficile ( C. difficile ).
  • C. difficile causes colitis by producing toxins that damage the lining of the colon.
  • The symptoms of C. difficile colitis are fever, diarrhea, and abdominal pain.
  • Serious complications of C. difficile colitis include dehydration, rupture of the colon, and spread of infection to the abdominal cavity or body. Severe infection is life-threatening.
  • The most common cause of C. difficle colitis is treatment with antibiotics. The antibiotics are believed to suppress normal colonic bacteria that usually keep C. difficile from multiplying and causing colitis.
  • Most cases of C. difficile colitis occur in patients in the hospital, but the number of cases that occur among individuals not having been in or recently discharged from the hospital has increased greatly.
  • The primary means of diagnosing C.difficile colitis is by testing for the bacterial toxins in samples of stool.
  • The treatment of C. difficile colitis is with antibiotics, primarily vancomycin and metronidazole. Up to 10% of patients do not respond to a course of one of the antibiotics and require retreatment, more prolonged treatment or treatment with a different antibiotic. Ten to 20 percent of patients who are successfully treated by their first course of antibiotics have a relapse of the colitis after the antibiotics are stopped.
  • Among patients who relapse, additional treatment with antibiotics is less successful than the initial treatment in permanently curing the colitis, and multiple relapses in these patients are common.
  • Among the treatments for multiple relapses of C. difficile colitis, a widely studied and effective treatment is transplantation of fecal bacteria from relatives or stool banks.
Medically Reviewed by a Doctor on 5/13/2015

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