• Bacterial infection affecting the colon caused by Clostridium difficile overgrowth
• Linked to disrupted gut microbiota after antibiotic use
• Ranges from mild diarrhea to severe life-threatening colitis.

• Gram-positive rod bacterium
• Produces exotoxins causing intestinal damage and pseudomembranous colitis
• Commonly develops when normal gut flora is suppressed by antibiotics (e.g., Clindamycin, cephalosporins).

• Caused by Clostridium difficile bacterium
• Produces toxins that damage the colon’s lining
• Commonly acquired in healthcare settings, particularly after antibiotic use.

• Recent broad-spectrum antibiotic use
• Older age
• Prolonged hospitalization
• Previous CDI episodes
• Immunocompromised state
• Gastrointestinal procedures or surgery
• Use of certain medications like proton pump inhibitors.

• Clostridium difficile bacteria produce toxins A and B
• These toxins damage the intestinal lining causing inflammation
• Inflammation results in symptoms like diarrhea, mucosal injury, and colitis
• Disruption of normal gut microbiota (often due to antibiotic use) allows Clostridium difficile to overgrow
• Toxins are central to the severity of the infection.

• Viral gastroenteritis
• Inflammatory bowel disease (e.g., Ulcerative Colitis, Crohn’s disease)
• Irritable bowel syndrome
• Other bacterial infections (e.g., Salmonella, Campylobacter).

• Significant healthcare-associated infection
• Incidence declining with improved infection control
• Remains a burden on healthcare systems, especially in elderly and immunocompromised patients.

• Diarrhea (often watery)
• Abdominal pain
• Fever
• Loss of appetite
• Nausea.

• Profuse diarrhea
• High fever
• Abdominal distension
• Signs of systemic inflammation.

• Toxic megacolon
• Sepsis
• Death.

• Mild: Normal WCC, 3-5 loose stools/day, or temp >38.5°C
• Moderate: Increased WCC (<15 x 10^9/L) or acutely ↑ creatinine (>50% above baseline)
• Severe: Increased WCC (>15 x 10^9/L) or severe colitis signs
• Life-threatening: Hypotension, partial/complete ileus, toxic megacolon, or severe disease on CT.

• Stool tests to detect CDI toxins or bacteria
• Enzyme immunoassays
• PCR assays.

• Necessary in severe cases for further evaluation.

• Detection of Clostridium difficile toxin (CDT) in stool
• Positive Clostridium difficile antigen indicates exposure, not necessarily current infection.

• Discontinue the causative antibiotics
• Start oral vancomycin or fidaxomicin.

• Hospitalization with IV fluids and close monitoring.

• Consider Fecal Microbiota Transplantation (FMT).

• Implement strict infection control protocols in healthcare settings.

• First episode: Oral vancomycin for 10 days; consider fidaxomicin if necessary
• Recurrent episode: Fidaxomicin within 12 weeks of symptom resolution; vancomycin or fidaxomicin if after 12 weeks
• Life-threatening CDI: Oral vancomycin and IV metronidazole; seek specialist advice and consider surgery
• Additional therapies: Bezlotoxumab or FMT for recurrent cases.

• Severity of infection
• The patient’s overall health status.

• Mild cases: Typically resolve with treatment
• Severe cases: Can be life-threatening.

• High risk of recurrence, especially with multiple episodes or existing risk factors.

• They significantly improve outcomes.

• Severe colitis
• Toxic megacolon
• Bowel perforation
• Sepsis
• Death.

• Recurrent episodes leading to prolonged illness
• Increased healthcare costs.